11D2287771 CLIA NUMBER - NORTH ATLANTA PRIMARY CARE DBA MIDDLE GEORGIA PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 11D2287771
  • Facility Name: NORTH ATLANTA PRIMARY CARE DBA MIDDLE GEORGIA PRIMARY CARE
  • Facility Address: 1115 MORNINGSIDE DRIVE
    PERRY, GA
    ZIP 31069
  • Facility Phone: 770 442-1911
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: APPAVUCHETTY SOUNDAPPAN
  • NPI Number: 1558803486
  • Taxonomy: 363AM0700X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 11D2287771
LAB Type Physician Office
Facility Name NORTH ATLANTA PRIMARY CARE DBA MIDDLE GEORGIA PRIMARY CARE
Street 1115 MORNINGSIDE DRIVE
City PERRY
State GA
ZIP 31069
Phone 770 442-1911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Physician Office
Lab Director APPAVUCHETTY SOUNDAPPAN

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