11D2310371 CLIA NUMBER - DAWN PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 11D2310371
  • Facility Name: DAWN PRIMARY CARE
  • Facility Address: 3595 CANTON ROAD, SUITE 314
    MARIETTA, GA
    ZIP 30066
  • Facility Phone: 678 932-2138
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AGHOGHO OMENE-IRORO
  • NPI Number: 1427830033
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 11D2310371
LAB Type Physician Office
Facility Name DAWN PRIMARY CARE
Street 3595 CANTON ROAD, SUITE 314
City MARIETTA
State GA
ZIP 30066
Phone 678 932-2138
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Physician Office
Lab Director AGHOGHO OMENE-IRORO

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This page was last updated on: 6/4/2025