11D2327908 CLIA NUMBER - COMPREHENSIVE BREAST CARE CENTER - VILLA RICA

Laboratory Demographics

  • CLIA Code: 11D2327908
  • Facility Name: COMPREHENSIVE BREAST CARE CENTER - VILLA RICA
  • Facility Address: 690 DALLAS HWY, STE 207-B
    VILLA RICA, GA
    ZIP 30180
  • Facility Phone: 770 812-5886
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAUL ZUNZUNEGUI
  • NPI Number: 1376050971
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2327908
LAB Type Physician Office
Facility Name COMPREHENSIVE BREAST CARE CENTER - VILLA RICA
Street 690 DALLAS HWY, STE 207-B
City VILLA RICA
State GA
ZIP 30180
Phone 770 812-5886
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2025
Certificate Expiration Date 7/30/2027
Facility Type Physician Office
Lab Director RAUL ZUNZUNEGUI

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