11D2302177 CLIA NUMBER - NORTHSIDE FORSYTH FAMILY MEDICINE & GERIATRICS

Laboratory Demographics

  • CLIA Code: 11D2302177
  • Facility Name: NORTHSIDE FORSYTH FAMILY MEDICINE & GERIATRICS
  • Facility Address: 1400 NORTHSIDE DRIVE, SUITE 200
    CUMMING, GA
    ZIP 30041
  • Facility Phone: 770 898-8388
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HEMEN PADHIAR
  • NPI Number: 1881460236
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2302177
LAB Type Physician Office
Facility Name NORTHSIDE FORSYTH FAMILY MEDICINE & GERIATRICS
Street 1400 NORTHSIDE DRIVE, SUITE 200
City CUMMING
State GA
ZIP 30041
Phone 770 898-8388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2024
Certificate Expiration Date 4/4/2026
Facility Type Physician Office
Lab Director HEMEN PADHIAR

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