CLIA lab
CLIA 11D0903117: Emory at Mountain Park Primary Care
Lilburn, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D0903117 belongs to Emory at Mountain Park Primary Care in Lilburn, GA.
Certificate of Waiver, effective July 2, 2025, expires July 1, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- July 2, 2025
- Certificate expiration
- July 1, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 3, 1996
- Facility type
- Physician office
- Ownership (control type)
- Other
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D0903117
- Lab name
- Emory at Mountain Park Primary Care
- Address
- 4120 Five Forks-Trickum Rd SW Ste 104, Lilburn, GA 30047
- Phone
- (404) 778-0644
- Fax
- (770) 923-1839
Annual test volume the lab reported
- Waived tests
- 2,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Emory at Mountain Park Primary Care in Lilburn?
11D0903117, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Emory at Mountain Park Primary Care hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D0903117 expire?
The CMS file lists July 1, 2027 as the certificate expiration date; the certificate took effect July 2, 2025.