11D2070373 CLIA NUMBER - COMMUNITY MD (TUCKER)

Laboratory Demographics

  • CLIA Code: 11D2070373
  • Facility Name: COMMUNITY MD (TUCKER)
  • Facility Address: 1475 MONTREAL ROAD, EAST
    TUCKER, GA
    ZIP 30084
  • Facility Phone: 678 292-6606
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ZAVIER ASH
  • NPI Number: 1295131530
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2070373
LAB Type Physician Office
Facility Name COMMUNITY MD (TUCKER)
Street 1475 MONTREAL ROAD, EAST
City TUCKER
State GA
ZIP 30084
Phone 678 292-6606
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type Physician Office
Lab Director ZAVIER ASH

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