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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: August 30, 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
Phone(678) 417-0407
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
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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 NPPES & CMS

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

What is Gc Duluth Pediatrics, Inc.'s NPI number?

The NPI number for Gc Duluth Pediatrics, Inc. is 1922374297. It was assigned to this organization in the NPPES registry on March 30, 2012.

Where is Gc Duluth Pediatrics, Inc. located?

Gc Duluth Pediatrics, Inc. is located at 3435 Duluth Park Ln Ste A, Duluth, GA 30096. The listed phone number is (678) 417-0407.

What is Gc Duluth Pediatrics, Inc.'s specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Gc Duluth Pediatrics, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1019460) is associated with this NPI, valid through November 18, 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 Gc Duluth Pediatrics, Inc. was last updated on March 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.