11D2161221 CLIA NUMBER - COMPASS PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 11D2161221
  • Facility Name: COMPASS PRIMARY CARE, LLC
  • Facility Address: 1720 PHOENIX BOULEVARD, SUITE 700
    COLLEGE PARK, GA
    ZIP 30349
  • Facility Phone: 470 369-7800
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KAREN Y. LUSTER
  • NPI Number: 1508340860
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2161221
LAB Type Physician Office
Facility Name COMPASS PRIMARY CARE, LLC
Street 1720 PHOENIX BOULEVARD, SUITE 700
City COLLEGE PARK
State GA
ZIP 30349
Phone 470 369-7800
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Physician Office
Lab Director KAREN Y. LUSTER

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