11D2291828 CLIA NUMBER - PEDSMD PEDIATRIC URGENT CARE

Laboratory Demographics

  • CLIA Code: 11D2291828
  • Facility Name: PEDSMD PEDIATRIC URGENT CARE
  • Facility Address: 4941 S OLD PEACHTREE ROAD, SUITE B
    NORCROSS, GA
    ZIP 30092
  • Facility Phone: 678 960-8316
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: FABIAN CHANG
  • NPI Number: 1659064921
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2291828
LAB Type Physician Office
Facility Name PEDSMD PEDIATRIC URGENT CARE
Street 4941 S OLD PEACHTREE ROAD, SUITE B
City NORCROSS
State GA
ZIP 30092
Phone 678 960-8316
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Physician Office
Lab Director FABIAN CHANG

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