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11D0934165 CLIA NUMBER - TOTAL HEALTH MEDICAL CENTER CORP

Laboratory Demographics

CLIA Number: 11D0934165

Facility Name: TOTAL HEALTH MEDICAL CENTER CORP

Facility Address:
4153 FLATSHOALS PKWY, BLDG A STE 104
DECATUR, GA
ZIP 30034
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Facility Phone Number: 404 657-5442

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1801162201

Taxonomy: 183500000X - Pharmacist
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

CLIA Record

Field Name Field Value
CLIA Number 11D0934165
LAB Type Physician Office
Facility Name TOTAL HEALTH MEDICAL CENTER CORP
Street 4153 FLATSHOALS PKWY, BLDG A STE 104
City DECATUR
State GA
ZIP 30034
Phone 404 657-5442
CertificateType 4
CertificateEffectiveDate 11/14/2022
CertificateExpirationDate 11/13/2024
FacilityType Waiver

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