11D0872045 CLIA NUMBER - WILLOWWOOD HEALTHCARE AND REHAB

Laboratory Demographics

  • CLIA Code: 11D0872045
  • Facility Name: WILLOWWOOD HEALTHCARE AND REHAB
  • Facility Address: 4595 CANTRELL ROAD
    FLOWERY BRANCH, GA
    ZIP 30542
  • Facility Phone: 770 967-2070
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TAMARA C. GENTLES
  • NPI Number: 1871130229
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D0872045
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WILLOWWOOD HEALTHCARE AND REHAB
Street 4595 CANTRELL ROAD
City FLOWERY BRANCH
State GA
ZIP 30542
Phone 770 967-2070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director TAMARA C. GENTLES

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