11D2000473 CLIA NUMBER - PICKFORD MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 11D2000473
  • Facility Name: PICKFORD MEDICAL CLINIC
  • Facility Address: 7810 MCGINNIS FERRY ROAD SUITE 108
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 770 622-9446
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JILL A. RUSSELL
  • NPI Number: 1255665170
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2000473
LAB Type Physician Office
Facility Name PICKFORD MEDICAL CLINIC
Street 7810 MCGINNIS FERRY ROAD SUITE 108
City SUWANEE
State GA
ZIP 30024
Phone 770 622-9446
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Physician Office
Lab Director JILL A. RUSSELL

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This page was last updated on: 9/29/2025