11D2300816 CLIA NUMBER - VITALX WELLNESS LLC

Laboratory Demographics

  • CLIA Code: 11D2300816
  • Facility Name: VITALX WELLNESS LLC
  • Facility Address: 10955 JONES BRIDGE ROAD, SUITE 126 #15
    JOHNS CREEK, GA
    ZIP 30022
  • Facility Phone: (405) 426-5093
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KHURRAM A. KHAN
  • NPI Number: 1437917143
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2300816
LAB Type Physician Office
Facility Name VITALX WELLNESS LLC
Street 10955 JONES BRIDGE ROAD, SUITE 126 #15
City JOHNS CREEK
State GA
ZIP 30022
Phone 4054265093
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2026
Certificate Expiration Date 3/14/2028
Facility Type Physician Office
Lab Director DR. KHURRAM A. KHAN

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This page was last updated on: 5/18/2026