11D2298204 CLIA NUMBER - PRIME CARE AND PATHOLOGY, INC

Laboratory Demographics

  • CLIA Code: 11D2298204
  • Facility Name: PRIME CARE AND PATHOLOGY, INC
  • Facility Address: 1050 GREEN STREET, SE
    CONYERS, GA
    ZIP 30012
  • Facility Phone: 678 591-6509
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: JACKSON GATES
  • NPI Number: 1144977802
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2298204
LAB Type Independent
Facility Name PRIME CARE AND PATHOLOGY, INC
Street 1050 GREEN STREET, SE
City CONYERS
State GA
ZIP 30012
Phone 678 591-6509
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Independent
Lab Director JACKSON GATES

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