11D2184072 CLIA NUMBER - TOTAL CARE PEDIATRICS, LLC

Laboratory Demographics

  • CLIA Code: 11D2184072
  • Facility Name: TOTAL CARE PEDIATRICS, LLC
  • Facility Address: 3672 MARATHON CIRCLE SUITE 140
    AUSTELL, GA
    ZIP 30106
  • Facility Phone: 470 502-0202
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MELVIN G. PERRY
  • NPI Number: 1134751068
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2184072
LAB Type Physician Office
Facility Name TOTAL CARE PEDIATRICS, LLC
Street 3672 MARATHON CIRCLE SUITE 140
City AUSTELL
State GA
ZIP 30106
Phone 470 502-0202
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Physician Office
Lab Director MELVIN G. PERRY

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