11D2050205 CLIA NUMBER - MY FAMILY DOC, LLC

Laboratory Demographics

  • CLIA Code: 11D2050205
  • Facility Name: MY FAMILY DOC, LLC
  • Facility Address: 101 ADAMS DRIVE
    DEMOREST, GA
    ZIP 30535
  • Facility Phone: 706 778-3912
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAVIN B. TALATI
  • NPI Number: 1346580982
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2050205
LAB Type Physician Office
Facility Name MY FAMILY DOC, LLC
Street 101 ADAMS DRIVE
City DEMOREST
State GA
ZIP 30535
Phone 706 778-3912
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Physician Office
Lab Director RAVIN B. TALATI

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