BURGEON MEDIX LLC
NPI 1134079973
Clinical Medical Laboratory in Snellville, GA

Active since January 31, 2026CLIA 11D2339742 · Waiver
2336 WISTERIA DR STE 510, SNELLVILLE, GA 30078(470) 469-1945 Get Directions Write a Review

NPPES record last updated: February 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 6, 2026, Jan 31, 2026 (2 updates tracked since 2026).

About Burgeon Medix Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BURGEON MEDIX LLC (NPI 1134079973) is a healthcare organization registered as a clinical medical laboratory in Snellville, Georgia and active in the NPI registry since January 2026. The organization holds a CLIA Waiver certificate valid through March 5, 2028 and lists Queen-esther Adaobi Raphael, Lab Director, as its authorized official.

NPPES Registry Identity

NPI1134079973
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameBURGEON MEDIX LLC
Location Address2336 WISTERIA DR STE 510Snellville, GA 30078-6159
Mailing Address2336 Wisteria Dr Ste 510Snellville, GA 30078-6159 · (470) 469-1945
Organization SubpartNo
Authorized OfficialQueen-esther Adaobi RaphaelLab Director · (470) 469-1945
Enumeration DateJanuary 31, 2026
Last NPPES UpdateFebruary 6, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2026
NPI 1134079973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
2336 WISTERIA DR STE 510, Snellville, GA 30078

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2339742

Burgeon Medix · Dacula, GA
Active · expires Mar 5, 2028
CLIA Number11D2339742
Laboratory TypeMobile Laboratory
Certificate Effective DateMarch 6, 2026
Certificate Expiration DateMarch 5, 2028
Laboratory DirectorQueen Esther A. Raphael
Laboratory Phone(470) 469-1945
Laboratory LocationBurgeon Medix2665 Ridge Manor Drive, SE, Dacula, GA 30019
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Burgeon Medix LLC's NPI number?

The NPI number for Burgeon Medix LLC is 1134079973. It was assigned to this organization in the NPPES registry on January 31, 2026.

Where is Burgeon Medix LLC located?

Burgeon Medix LLC is located at 2336 Wisteria Dr Ste 510, Snellville, GA 30078. The listed phone number is (470) 469-1945.

What is Burgeon Medix LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Burgeon Medix LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2339742) is associated with this NPI, valid through March 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Burgeon Medix LLC was last updated on February 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.