11D2014967 CLIA NUMBER - RODRIGUEZ MD

Laboratory Demographics

  • CLIA Code: 11D2014967
  • Facility Name: RODRIGUEZ MD
  • Facility Address: 771 OLD NORCROSS ROAD, SUITE 120 TERRECE PARK MED CTR
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 770 670-6920
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEBORAH RODRIGUEZ
  • NPI Number: 1568778306
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2014967
LAB Type Physician Office
Facility Name RODRIGUEZ MD
Street 771 OLD NORCROSS ROAD, SUITE 120 TERRECE PARK MED CTR
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 770 670-6920
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Physician Office
Lab Director DEBORAH RODRIGUEZ

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