11D0722553 CLIA NUMBER - PRUITT HEALTH- BROOKHAVEN, LLC

Laboratory Demographics

  • CLIA Code: 11D0722553
  • Facility Name: PRUITT HEALTH- BROOKHAVEN, LLC
  • Facility Address: 3535 ASHTON WOODS DRIVE
    ATLANTA, GA
    ZIP 30319
  • Facility Phone: 404 451-0236
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DAVID PRESCOTT
  • NPI Number: 1336196468
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D0722553
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRUITT HEALTH- BROOKHAVEN, LLC
Street 3535 ASHTON WOODS DRIVE
City ATLANTA
State GA
ZIP 30319
Phone 404 451-0236
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DAVID PRESCOTT

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This page was last updated on: 9/29/2025