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11D0256595 CLIA NUMBER - PERISSEIA PHYSICIANS LLC

Laboratory Demographics

CLIA Number: 11D0256595

Facility Name: PERISSEIA PHYSICIANS LLC

Facility Address:
1655 LEBANON RD STE A
LAWRENCEVILLE, GA
ZIP 30043
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Facility Phone Number: 770 682-2024

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1992868855

Taxonomy: 173000000X - Legal Medicine
The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.

CLIA Record

Field Name Field Value
CLIA Number 11D0256595
LAB Type Physician Office
Facility Name PERISSEIA PHYSICIANS LLC
Street 1655 LEBANON RD STE A
City LAWRENCEVILLE
State GA
ZIP 30043
Phone 770 682-2024
CertificateType 4
CertificateEffectiveDate 2/14/2024
CertificateExpirationDate 2/13/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024