| KL Medical Clinic, LLC. | |
|
905 Parkside Walk Ln Ste 100a Lawrenceville GA 30043-7314 | |
| (678) 442-9486 | |
| (678) 442-9488 |
| Full Name | KL Medical Clinic, LLC. |
|---|---|
| Speciality | Clinic/center |
| Location | 905 Parkside Walk Ln Ste 100a, Lawrenceville, Georgia |
| Authorized Official Name and Position | Kenneth Ofoha (PRESIDENT/OWNER) |
| Authorized Official Contact | 6787737909 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| KL Medical Clinic, LLC. Po Box 492110 Lawrenceville GA 30049-0036 | KL Medical Clinic, LLC. 905 Parkside Walk Ln Ste 100a Lawrenceville GA 30043-7314 Ph: (678) 442-9486 |
| NPI Number | 1356692404 |
|---|---|
| Provider Enumeration Date | 09/28/2012 |
| Last Update Date | 03/24/2026 |
| Certification Date | 03/24/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356692404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 68463 (Georgia) | Primary |
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