11D2080809 CLIA NUMBER - CJ PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 11D2080809
  • Facility Name: CJ PEDIATRICS LLC
  • Facility Address: 225 COUNTRY CLUB DRIVE, SUITE 200
    STOCKBRIDGE, GA
    ZIP 30281
  • Facility Phone: 678 782-7137
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CANDACE J. JOHNSON
  • NPI Number: 1477966380
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2080809
LAB Type Physician Office
Facility Name CJ PEDIATRICS LLC
Street 225 COUNTRY CLUB DRIVE, SUITE 200
City STOCKBRIDGE
State GA
ZIP 30281
Phone 678 782-7137
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Physician Office
Lab Director CANDACE J. JOHNSON

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