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LIFEGUIDE HEALTH SERVICES
NPI 1508078973
Clinic/Center - Primary Care in Lilburn, GA

Active since May 05, 2007CLIA 11D2209606 · Waiver
656 INDIAN TRAIL LILBURN RD NW STE 208, LILBURN, GA 30047(770) 557-1079 Get Directions Write a Review

NPPES record last updated: May 24, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 24, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Lifeguide Health Services NPPES

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

LIFEGUIDE HEALTH SERVICES (NPI 1508078973) is a healthcare organization registered as a primary care in Lilburn, Georgia and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through October 30, 2027, maintains a secondary practice location in Forest Park, and lists Latesha Johnson, Manager, as its authorized official.

NPPES Registry Identity

NPI1508078973
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameLIFEGUIDE, INC
Location Address656 INDIAN TRAIL LILBURN RD NW STE 208Lilburn, GA 30047-6872
Mailing Address519 Forest Pkwy, Suite 270Forest Park, GA 30297-6142 · (404) 363-6922 · Fax (404) 363-6925
Phone(770) 557-1079
Organization SubpartNo
Authorized OfficialLatesha JohnsonManager · (317) 820-7582
Enumeration DateMay 5, 2007
Last NPPES UpdateMay 24, 20222 updates tracked since enumeration
NPPES CertifiedMay 24, 2022
✔ NPI 1508078973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedHome HealthTaxonomy 251E00000X · License 031-R-0050 (GA)
656 INDIAN TRAIL LILBURN RD NW STE 208, Lilburn, GA 30047
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Other Names 2

Doing Business AsLifeguide Health Services
Doing Business AsLifeguide Family Practice Llc

Secondary Practice Location 1

Location 1519 Forest Pkwy, Suite 270Forest Park, GA 30297-6142 · Phone (404) 363-6922 · Fax (404) 363-6925

Other Identifiers 2

Medicaid276046116AGA
Medicaid838117320AGA

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 11D2209606

Lifeguide Healthcare · Sandy Springs, GA
Active · expires Oct 30, 2027
CLIA Number11D2209606
Laboratory TypePhysician Office
Certificate Effective DateOctober 31, 2025
Certificate Expiration DateOctober 30, 2027
Laboratory DirectorModupe O. Agbeyomi
Laboratory Phone(770) 557-1079
Laboratory LocationLifeguide Healthcare8601 Dunwoody Place, Suite 448, Sandy Springs, GA 30350
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.

LIFEGUIDE FAMILY PRACTICE LLC
Clinic/Center (Primary Care)
656 INDIAN TRAIL LILBURN RD NW STE 208
LILBURN, GA 30047
Gwinnett County (770) 557-1079
CLINICA FAMILIAR VIDA Y SALUD
Clinic/Center (Primary Care)
656 INDIAN TRAIL LILBURN RD NW STE 208
LILBURN, GA 30047
Gwinnett County (770) 696-9968

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 Lifeguide, Inc's NPI number?

The NPI number for Lifeguide, Inc is 1508078973. It was assigned to this organization in the NPPES registry on May 5, 2007. The provider is doing business as Lifeguide Health Services and Lifeguide Family Practice LLC.

Where is Lifeguide, Inc located?

Lifeguide, Inc is located at 656 Indian Trail Lilburn Rd NW Ste 208, Lilburn, GA 30047. The listed phone number is (770) 557-1079.

What is Lifeguide, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Lifeguide, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2209606) is associated with this NPI, valid through October 30, 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 Lifeguide, Inc was last updated on May 24, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.