11D2071754 CLIA NUMBER - PLEASANT PEDS CARE OF CONYERS

Laboratory Demographics

  • CLIA Code: 11D2071754
  • Facility Name: PLEASANT PEDS CARE OF CONYERS
  • Facility Address: 1298 WELLBROOK CIRCLE NE
    CONYERS, GA
    ZIP 30012
  • Facility Phone: 770 603-8083
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHYRONDA PLEASANT
  • NPI Number: 1053749457
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2071754
LAB Type Physician Office
Facility Name PLEASANT PEDS CARE OF CONYERS
Street 1298 WELLBROOK CIRCLE NE
City CONYERS
State GA
ZIP 30012
Phone 770 603-8083
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Physician Office
Lab Director SHYRONDA PLEASANT

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This page was last updated on: 6/4/2025