11D2280549 CLIA NUMBER - ZODIAC MEDICAL

Laboratory Demographics

  • CLIA Code: 11D2280549
  • Facility Name: ZODIAC MEDICAL
  • Facility Address: 1180 MCKENDREE CHURCH ROAD, SUITE 202
    LAWRENCEVILLE, GA
    ZIP 30043
  • Facility Phone: 770 277-6374
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONG V. DANG
  • NPI Number: 1083344576
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2280549
LAB Type Physician Office
Facility Name ZODIAC MEDICAL
Street 1180 MCKENDREE CHURCH ROAD, SUITE 202
City LAWRENCEVILLE
State GA
ZIP 30043
Phone 770 277-6374
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Physician Office
Lab Director DONG V. DANG

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