KL MEDICAL CLINIC, LLC.
NPI 1356692404
Clinic/Center in Lawrenceville, GA
NPI Status: Active since September 28, 2012
Contact Information
905 PARKSIDE WALK LN STE 100A
LAWRENCEVILLE, GA
ZIP 30043
Phone: (678) 442-9486
Fax: (678) 442-9488
- Organization
- Clinic/Center
- CLIA Number: 11D2050219
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-22-2027
About KL MEDICAL CLINIC, LLC.
This page provides the complete NPI Profile along with additional information for Kl Medical Clinic, Llc., a provider established in Lawrenceville, Georgia operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1356692404 assigned on September 2012. The practitioner's primary taxonomy code is 261Q00000X with license number 68463 (GA). The provider is registered as an organization and their NPI record was last updated March 2026. The authorized official of this NPI record is Dr. Kenneth Ofoha M.d. (President/owner)
- NPI
- 1356692404
- Provider Name
- KL MEDICAL CLINIC, LLC.
- Entity Type
- Organization
- Location Address
- 905 PARKSIDE WALK LN STE 100A LAWRENCEVILLE, GA 30043
- Location Phone
- (678) 442-9486
- Location Fax
- (678) 442-9488
- Mailing Address
- PO BOX 492110 LAWRENCEVILLE, GA 30049
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-28-2012
- Last Update Date
- 03-24-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 68463
- License State
- GA
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2050219
- Facility Type
- Physician Office
- Certificate Effective Date
- October 23, 2025
- Certificate Expiration Date
- October 22, 2027
- Laboratory Director
- KENNETH O. OFOHA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Kl Medical Clinic, Llc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1356692404, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
LAWRENCEVILLE, GA 30043
LAWRENCEVILLE, GA 30043
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1356692404, enumerated as an "organization" on September 28, 2012.
The provider is located at 905 PARKSIDE WALK LN STE 100A LAWRENCEVILLE, GA 30043 and the phone number is (678) 442-9486.
Clinic/Center with taxonomy code 261Q00000X.
