11D2262640 CLIA NUMBER - LIFELINE PRIMARY CARE/ AVACARE

Laboratory Demographics

  • CLIA Code: 11D2262640
  • Facility Name: LIFELINE PRIMARY CARE/ AVACARE
  • Facility Address: 3997 LAWRENCEVILLE HIGHWAY NW SUITE 1 & SUITE 4
    LILBURN, GA
    ZIP 30047
  • Facility Phone: 770 771-6150
  • Facility Type: Other - CLINICAL RESEARCH OFFICE
  • Facility Type: Waiver
  • Lab Director: AZIZ A. PIRANI
  • NPI Number: 1639426984
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2262640
LAB Type Other - CLINICAL RESEARCH OFFICE
Facility Name LIFELINE PRIMARY CARE/ AVACARE
Street 3997 LAWRENCEVILLE HIGHWAY NW SUITE 1 & SUITE 4
City LILBURN
State GA
ZIP 30047
Phone 770 771-6150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2024
Certificate Expiration Date 6/15/2026
Facility Type Other - CLINICAL RESEARCH OFFICE
Lab Director AZIZ A. PIRANI

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