11D2024050 CLIA NUMBER - HILLANDALE INTERNAL MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 11D2024050
  • Facility Name: HILLANDALE INTERNAL MEDICINE, PC
  • Facility Address: 5910 HILLANDALE DRIVE, SUITE 355
    LITHONIA, GA
    ZIP 30058
  • Facility Phone: 770 987-8400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WALLACE DUNCAN
  • NPI Number: 1861781320
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2024050
LAB Type Physician Office
Facility Name HILLANDALE INTERNAL MEDICINE, PC
Street 5910 HILLANDALE DRIVE, SUITE 355
City LITHONIA
State GA
ZIP 30058
Phone 770 987-8400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Physician Office
Lab Director WALLACE DUNCAN

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