11D2322529 CLIA NUMBER - OPTIMUM PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 11D2322529
  • Facility Name: OPTIMUM PRIMARY CARE
  • Facility Address: 7145 CAVENDER DRIVE, SW
    ATLANTA, GA
    ZIP 30331
  • Facility Phone: 404 902-0821
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: NANCY E. BELLINGER
  • NPI Number: 1366252462
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D2322529
LAB Type Practitioner Other
Facility Name OPTIMUM PRIMARY CARE
Street 7145 CAVENDER DRIVE, SW
City ATLANTA
State GA
ZIP 30331
Phone 404 902-0821
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Practitioner Other
Lab Director NANCY E. BELLINGER

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