11D2236386 CLIA NUMBER - GCLAB LLC DBA DETECT & PROTECT

Laboratory Demographics

  • CLIA Code: 11D2236386
  • Facility Name: GCLAB LLC DBA DETECT & PROTECT
  • Facility Address: 635 GLYNN STREET NORTH SUITE 1 & 2
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 770 692-1241
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: GERMANUS EJIOGU
  • NPI Number: 1730843251
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 11D2236386
LAB Type Practitioner Other
Facility Name GCLAB LLC DBA DETECT & PROTECT
Street 635 GLYNN STREET NORTH SUITE 1 & 2
City FAYETTEVILLE
State GA
ZIP 30214
Phone 770 692-1241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Practitioner Other
Lab Director GERMANUS EJIOGU

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