GC DULUTH PEDIATRICS, INC.
NPI 1922374297
Pediatrics in Duluth, GA

Active since March 30, 2012CLIA 11D1019460 · Waiver
3435 DULUTH PARK LN STE A, DULUTH, GA 30096(678) 417-0407 Get Directions Write a Review

NPPES record last updated: March 30, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Gc Duluth Pediatrics, Inc. NPPES

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

GC DULUTH PEDIATRICS, INC. (NPI 1922374297) is a healthcare organization registered as a pediatrics in Duluth, Georgia and active in the NPI registry since March 2012. The organization holds a CLIA Waiver certificate valid through November 18, 2027 and lists Samuel Song, President, as its authorized official.

NPPES Registry Identity

NPI1922374297
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameGC DULUTH PEDIATRICS, INC.
Location Address3435 DULUTH PARK LN STE ADuluth, GA 30096-3259
Mailing Address3435 Duluth Park Ln Ste ADuluth, GA 30096-3259
Organization SubpartNo
Authorized OfficialSamuel SongPresident · (678) 417-0407
Enumeration DateMarch 30, 2012
NPI 1922374297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License Licensed in GA · 049206
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

3435 DULUTH PARK LN STE A, Duluth, GA 30096

Other Identifiers 1

Medicaid442074795AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 11D1019460

Gc Duluth Pediatrics Incorporate · Duluth, GA
Active · expires Nov 18, 2027
CLIA Number11D1019460
Laboratory TypePhysician Office
Certificate Effective DateNovember 19, 2025
Certificate Expiration DateNovember 18, 2027
Laboratory DirectorSam H. Song
Laboratory Phone(678) 417-0407
Laboratory LocationGc Duluth Pediatrics Incorporate3435 Duluth Park Lane Suite A, Duluth, GA 30096
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1922374297, enumerated as an "organization" on March 30, 2012.

The provider is located at 3435 DULUTH PARK LN STE A DULUTH, GA 30096 and the phone number is (678) 417-0407.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.