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11D0699534 CLIA NUMBER - EDWARD C MACK MD PC

Laboratory Demographics

CLIA Number: 11D0699534

Facility Name: EDWARD C MACK MD PC

Facility Address:
2855 CANDLER ROAD, SUITE 6
DECATUR, GA
ZIP 30034
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Facility Phone Number: 404 241-0103

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1619305661

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 11D0699534
LAB Type Physician Office
Facility Name EDWARD C MACK MD PC
Street 2855 CANDLER ROAD, SUITE 6
City DECATUR
State GA
ZIP 30034
Phone 404 241-0103
CertificateType 4
CertificateEffectiveDate 11/9/2022
CertificateExpirationDate 11/8/2024
FacilityType Waiver

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