11D2141641 CLIA NUMBER - CORNERSTONE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D2141641
  • Facility Name: CORNERSTONE PEDIATRICS
  • Facility Address: 2700 BRASELTON HIGHWAY, SUITE 1
    DACULA, GA
    ZIP 30019
  • Facility Phone: 404 394-8001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER S. CANTRELL
  • NPI Number: 1295233211
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2141641
LAB Type Physician Office
Facility Name CORNERSTONE PEDIATRICS
Street 2700 BRASELTON HIGHWAY, SUITE 1
City DACULA
State GA
ZIP 30019
Phone 404 394-8001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Physician Office
Lab Director JENNIFER S. CANTRELL

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