CLIA lab
CLIA 11D1004979: Northside Lithonia Primary Care
Lithonia, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D1004979 belongs to Northside Lithonia Primary Care in Lithonia, GA.
Certificate of Waiver, effective October 10, 2026, expires October 9, 2028.
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
- October 10, 2026
- Certificate expiration
- October 9, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 10, 2002
- Facility type
- Physician office
- Ownership (control type)
- Private
- 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
- 11D1004979
- Lab name
- Northside Lithonia Primary Care
- Address
- 6000 Hillandale Dr. Suite 100, Lithonia, GA 30058
- Phone
- (678) 418-2120
- Fax
- (678) 418-2936
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Related
Questions
What is the CLIA number for Northside Lithonia Primary Care in Lithonia?
11D1004979, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Northside Lithonia Primary Care hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D1004979 expire?
The CMS file lists October 9, 2028 as the certificate expiration date; the certificate took effect October 10, 2026.