11D2305983 CLIA NUMBER - FIRSTSTOP MEDICAL CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 11D2305983
  • Facility Name: FIRSTSTOP MEDICAL CLINIC, LLC
  • Facility Address: 3375 MEMORIAL DRIVE, SUITE G
    DECATUR, GA
    ZIP 30032
  • Facility Phone: 404 494-6774
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GLORY DIOH-ESONA
  • NPI Number: 1538912423
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D2305983
LAB Type Physician Office
Facility Name FIRSTSTOP MEDICAL CLINIC, LLC
Street 3375 MEMORIAL DRIVE, SUITE G
City DECATUR
State GA
ZIP 30032
Phone 404 494-6774
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Physician Office
Lab Director GLORY DIOH-ESONA

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