11D2125685 CLIA NUMBER - DACULA PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D2125685
  • Facility Name: DACULA PEDIATRICS
  • Facility Address: 3625 BRASELTON HIGHWAY, SUITE 202
    DACULA, GA
    ZIP 30019
  • Facility Phone: 470 655-7166
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SARVPREET KAUR
  • NPI Number: 1033655576
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2125685
LAB Type Physician Office
Facility Name DACULA PEDIATRICS
Street 3625 BRASELTON HIGHWAY, SUITE 202
City DACULA
State GA
ZIP 30019
Phone 470 655-7166
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Physician Office
Lab Director SARVPREET KAUR

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