11D2012609 CLIA NUMBER - SPECTRUM INTERNAL MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 11D2012609
  • Facility Name: SPECTRUM INTERNAL MEDICINE, LLC
  • Facility Address: 401 S MAIN STREET, SUITE C7
    ALPHARETTA, GA
    ZIP 30009
  • Facility Phone: 678 319-9901
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JULIUS K. ADEBISI
  • NPI Number: 1437576659
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2012609
LAB Type Physician Office
Facility Name SPECTRUM INTERNAL MEDICINE, LLC
Street 401 S MAIN STREET, SUITE C7
City ALPHARETTA
State GA
ZIP 30009
Phone 678 319-9901
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2024
Certificate Expiration Date 9/7/2026
Facility Type Physician Office
Lab Director JULIUS K. ADEBISI

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