11D0720188 CLIA NUMBER - ALPHARETTA INTERNAL MEDICINE

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Laboratory Demographics

CLIA Number: 11D0720188

Facility Name: ALPHARETTA INTERNAL MEDICINE

Facility Address:
1380 UPPER HEMBREE ROAD
ROSWELL, GA
ZIP 30076
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Facility Phone Number: 770 475-2377

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1770799702

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D0720188
LAB Type	Physician Office
Facility Name	ALPHARETTA INTERNAL MEDICINE
Street	1380 UPPER HEMBREE ROAD
City	ROSWELL
State	GA
ZIP	30076
Phone	770 475-2377
CertificateType	3
CertificateEffectiveDate	7/1/2022
CertificateExpirationDate	6/30/2024
FacilityType	PPMP

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