11D2277193 CLIA NUMBER - INNER COMMUNITY HEALTH

Laboratory Demographics

  • CLIA Code: 11D2277193
  • Facility Name: INNER COMMUNITY HEALTH
  • Facility Address: 10700 MEDLOCK BRIDGE ROAD, SUITE 104
    DULUTH, GA
    ZIP 30097
  • Facility Phone: 800 620-6950
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIRICA A. SANDERS
  • NPI Number: 1891398541
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2277193
LAB Type Physician Office
Facility Name INNER COMMUNITY HEALTH
Street 10700 MEDLOCK BRIDGE ROAD, SUITE 104
City DULUTH
State GA
ZIP 30097
Phone 800 620-6950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2025
Certificate Expiration Date 1/15/2027
Facility Type Physician Office
Lab Director MIRICA A. SANDERS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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