11D2081168 CLIA NUMBER - BUCKHEAD PRIMARY CARE CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 11D2081168
  • Facility Name: BUCKHEAD PRIMARY CARE CLINIC, LLC
  • Facility Address: 1891 HOWELL MILL ROAD NW SUITE A
    ATLANTA, GA
    ZIP 30318
  • Facility Phone: 678 515-0688
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THINH D. NGUYEN
  • NPI Number: 1861811572
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2081168
LAB Type Physician Office
Facility Name BUCKHEAD PRIMARY CARE CLINIC, LLC
Street 1891 HOWELL MILL ROAD NW SUITE A
City ATLANTA
State GA
ZIP 30318
Phone 678 515-0688
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Physician Office
Lab Director THINH D. NGUYEN

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