11D2171122 CLIA NUMBER - MACLEY FAMILY PRACTICE & WALK IN CLINIC

Laboratory Demographics

  • CLIA Code: 11D2171122
  • Facility Name: MACLEY FAMILY PRACTICE & WALK IN CLINIC
  • Facility Address: 2282 MEADOW CHURCH ROAD
    DULUTH, GA
    ZIP 30097
  • Facility Phone: 678 257-2832
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CLEMENT AYANBADEJO
  • NPI Number: 1811553084
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2171122
LAB Type Physician Office
Facility Name MACLEY FAMILY PRACTICE & WALK IN CLINIC
Street 2282 MEADOW CHURCH ROAD
City DULUTH
State GA
ZIP 30097
Phone 678 257-2832
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Physician Office
Lab Director CLEMENT AYANBADEJO

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