11D2284603 CLIA NUMBER - MINDFUL PEDIATRICS & ADOLESCENT MEDICINE

Laboratory Demographics

  • CLIA Code: 11D2284603
  • Facility Name: MINDFUL PEDIATRICS & ADOLESCENT MEDICINE
  • Facility Address: 11705 JONES BRIDGE ROAD, SUITE A201
    JOHNS CREEK, GA
    ZIP 30005
  • Facility Phone: 770 746-7113
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRIYA S. THOMAS
  • NPI Number: 1891485462
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2284603
LAB Type Physician Office
Facility Name MINDFUL PEDIATRICS & ADOLESCENT MEDICINE
Street 11705 JONES BRIDGE ROAD, SUITE A201
City JOHNS CREEK
State GA
ZIP 30005
Phone 770 746-7113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2025
Certificate Expiration Date 6/26/2027
Facility Type Physician Office
Lab Director PRIYA S. THOMAS

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