11D2204882 CLIA NUMBER - LEXINGTON PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 11D2204882
  • Facility Name: LEXINGTON PRIMARY CARE, LLC
  • Facility Address: 777 ATHENS ROAD SUITE 102
    LEXINGTON, GA
    ZIP 30648
  • Facility Phone: 770 331-9113
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AFAQ A. GUL
  • NPI Number: 1942809108
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2204882
LAB Type Physician Office
Facility Name LEXINGTON PRIMARY CARE, LLC
Street 777 ATHENS ROAD SUITE 102
City LEXINGTON
State GA
ZIP 30648
Phone 770 331-9113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Physician Office
Lab Director AFAQ A. GUL

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