11D0257792 CLIA NUMBER - SANJEEV S TENDOLKAR MD LLC

Laboratory Demographics

CLIA Number: 11D0257792

Facility Name: SANJEEV S TENDOLKAR MD LLC

Facility Address:
4593 LAWRENCEVILLE ROAD
LOGANVILLE, GA
ZIP 30052
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Facility Phone Number: 770 466-8672

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1326258583

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	11D0257792
LAB Type	Physician Office
Facility Name	SANJEEV S TENDOLKAR MD LLC
Street	4593 LAWRENCEVILLE ROAD
City	LOGANVILLE
State	GA
ZIP	30052
Phone	770 466-8672
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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