11D2141458 CLIA NUMBER - KAISER PERMANENTE - GWINNETT COUNTY EMPLOYEE WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 11D2141458
  • Facility Name: KAISER PERMANENTE - GWINNETT COUNTY EMPLOYEE WELLNESS CENTER
  • Facility Address: 750 S PERRY STREET
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 770 931-6112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL C. GRIZZLE
  • NPI Number: 1033437629
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 11D2141458
LAB Type Physician Office
Facility Name KAISER PERMANENTE - GWINNETT COUNTY EMPLOYEE WELLNESS CENTER
Street 750 S PERRY STREET
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 770 931-6112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Physician Office
Lab Director DANIEL C. GRIZZLE

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