11D2186899 CLIA NUMBER - PRIME HEALTH MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D2186899
  • Facility Name: PRIME HEALTH MEDICAL CENTER
  • Facility Address: 3616 S BOGAN ROAD SUITE 202
    BUFORD, GA
    ZIP 30519
  • Facility Phone: 678 288-9740
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BUNMI FOLARINDE
  • NPI Number: 1326510652
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2186899
LAB Type Pharmacy
Facility Name PRIME HEALTH MEDICAL CENTER
Street 3616 S BOGAN ROAD SUITE 202
City BUFORD
State GA
ZIP 30519
Phone 678 288-9740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2024
Certificate Expiration Date 6/22/2026
Facility Type Pharmacy
Lab Director BUNMI FOLARINDE

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