11D2043142 CLIA NUMBER - NG MEDICAL GROUP, PC

Laboratory Demographics

  • CLIA Code: 11D2043142
  • Facility Name: NG MEDICAL GROUP, PC
  • Facility Address: 4355 BROWNS BRIDGE ROAD, SUITE 1 & 2
    CUMMING, GA
    ZIP 30041
  • Facility Phone: 770 771-5050
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DUSTIN L. RUSSELL
  • NPI Number: 1649536749
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2043142
LAB Type Physician Office
Facility Name NG MEDICAL GROUP, PC
Street 4355 BROWNS BRIDGE ROAD, SUITE 1 & 2
City CUMMING
State GA
ZIP 30041
Phone 770 771-5050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Physician Office
Lab Director DR. DUSTIN L. RUSSELL

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