11D2150390 CLIA NUMBER - JOHNS CREEK PEDIATRICS NORTH SATELLITE LOCATION

Laboratory Demographics

  • CLIA Code: 11D2150390
  • Facility Name: JOHNS CREEK PEDIATRICS NORTH SATELLITE LOCATION
  • Facility Address: 2000 HOWARD FARM DRIVE, SUITE 320
    CUMMING, GA
    ZIP 30041
  • Facility Phone: 770 814-1160
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAREN DEWLING
  • NPI Number: 1215177753
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2150390
LAB Type Physician Office
Facility Name JOHNS CREEK PEDIATRICS NORTH SATELLITE LOCATION
Street 2000 HOWARD FARM DRIVE, SUITE 320
City CUMMING
State GA
ZIP 30041
Phone 770 814-1160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2024
Certificate Expiration Date 6/24/2026
Facility Type Physician Office
Lab Director KAREN DEWLING

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This page was last updated on: 3/20/2025