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KL MEDICAL CLINIC, LLC.
NPI 1356692404
Clinic/Center in Lawrenceville, GA

Active since September 28, 2012CLIA 11D2050219 · Waiver
905 PARKSIDE WALK LN STE 100A, LAWRENCEVILLE, GA 30043(678) 442-9486(678) 442-9488 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 24, 2026, Jul 19, 2023, Jun 26, 2018 (3 updates tracked since 2018).

About Kl Medical Clinic, Llc. NPPES

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

KL MEDICAL CLINIC, LLC. (NPI 1356692404) is a healthcare organization registered as a clinic/center in Lawrenceville, Georgia and active in the NPI registry since September 2012. The organization holds a CLIA Waiver certificate valid through October 22, 2027 and lists Kenneth Ofoha, President/owner, as its authorized official.

NPPES Registry Identity

NPI1356692404
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameKL MEDICAL CLINIC, LLC.
Location Address905 PARKSIDE WALK LN STE 100ALawrenceville, GA 30043-7314
Mailing AddressPo Box 492110Lawrenceville, GA 30049-0036
Phone(678) 442-9486
Fax(678) 442-9488
Organization SubpartNo
Authorized OfficialKenneth OfohaPresident/owner · (678) 773-7909
Enumeration DateSeptember 28, 2012
Last NPPES UpdateMarch 24, 20263 updates tracked since enumeration
NPPES CertifiedMarch 24, 2026
✔ NPI 1356692404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in GA · 68463
Definition
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).
905 PARKSIDE WALK LN STE 100A, Lawrenceville, GA 30043
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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 11D2050219

Kl Medical Clinic, LLC · Lawrenceville, GA
Active · expires Oct 22, 2027
CLIA Number11D2050219
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2025
Certificate Expiration DateOctober 22, 2027
Laboratory DirectorKenneth O. Ofoha
Laboratory Phone(678) 442-9486
Laboratory LocationKl Medical Clinic, LLC905 Parkside Walk Lane, Suite 100 A, Lawrenceville, GA 30043
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA L OFOHA FNP-BC
Nurse Practitioner (Family)
905 PARKSIDE WALK LN STE 100A
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 442-9486
DR. KENNETH ONYEKWERE OFOHA M.D.
Emergency Medicine
905 PARKSIDE WALK LN STE 100A
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 442-9486

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 Kl Medical Clinic, LLC.'s NPI number?

The NPI number for Kl Medical Clinic, LLC. is 1356692404. It was assigned to this organization in the NPPES registry on September 28, 2012.

Where is Kl Medical Clinic, LLC. located?

Kl Medical Clinic, LLC. is located at 905 Parkside Walk Ln Ste 100A, Lawrenceville, GA 30043. The listed phone number is (678) 442-9486.

What is Kl Medical Clinic, LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Kl Medical Clinic, LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2050219) is associated with this NPI, valid through October 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kl Medical Clinic, LLC. was last updated on March 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.