11D2122190 CLIA NUMBER - MINOR MEDICAL HEALTHCARE DBA LIFESTYLE PAIN MGMT & WELLNESS

Laboratory Demographics

  • CLIA Code: 11D2122190
  • Facility Name: MINOR MEDICAL HEALTHCARE DBA LIFESTYLE PAIN MGMT & WELLNESS
  • Facility Address: 1976 MAIN STREET EAST, UNIT C
    SNELLVILLE, GA
    ZIP 30078
  • Facility Phone: 912 342-2443
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. FELIX OMORUYI
  • NPI Number: 1780120188
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2122190
LAB Type Physician Office
Facility Name MINOR MEDICAL HEALTHCARE DBA LIFESTYLE PAIN MGMT & WELLNESS
Street 1976 MAIN STREET EAST, UNIT C
City SNELLVILLE
State GA
ZIP 30078
Phone 912 342-2443
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Physician Office
Lab Director DR. FELIX OMORUYI

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