11D2266770 CLIA NUMBER - LIFELINE PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 11D2266770
  • Facility Name: LIFELINE PRIMARY CARE INC
  • Facility Address: 4855 RIVER GREEN PARKWAY, SUITE 700
    DULUTH, GA
    ZIP 30096
  • Facility Phone: (770) 545-8332
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAFLA PIRANI
  • NPI Number: 1780477893
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2266770
LAB Type Physician Office
Facility Name LIFELINE PRIMARY CARE INC
Street 4855 RIVER GREEN PARKWAY, SUITE 700
City DULUTH
State GA
ZIP 30096
Phone 7705458332
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Physician Office
Lab Director SAFLA PIRANI

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This page was last updated on: 5/18/2026