11D2327347 CLIA NUMBER - NCR MEDICAL LAB, LLC

Laboratory Demographics

  • CLIA Code: 11D2327347
  • Facility Name: NCR MEDICAL LAB, LLC
  • Facility Address: 168 N JOHNSTON STREET, SUITE #300
    DALLAS, GA
    ZIP 30132
  • Facility Phone: 877 822-2349
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: NAOMI C. RENFROE
  • NPI Number: 1952111981
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 11D2327347
LAB Type Independent
Facility Name NCR MEDICAL LAB, LLC
Street 168 N JOHNSTON STREET, SUITE #300
City DALLAS
State GA
ZIP 30132
Phone 877 822-2349
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Independent
Lab Director NAOMI C. RENFROE

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