11D0984560 CLIA NUMBER - SUMMERSET ASSISTED LIVING COMMUNITY

Laboratory Demographics

CLIA Number: 11D0984560

Facility Name: SUMMERSET ASSISTED LIVING COMMUNITY

Facility Address:
3711 BENJAMIN E MAYS DR SW
ATLANTA, GA
ZIP 30331
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Facility Phone Number: 404 691-4545

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1366963019

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D0984560
LAB Type	Other
Facility Name	SUMMERSET ASSISTED LIVING COMMUNITY
Street	3711 BENJAMIN E MAYS DR SW
City	ATLANTA
State	GA
ZIP	30331
Phone	404 691-4545
CertificateType	4
CertificateEffectiveDate	3/23/2023
CertificateExpirationDate	3/22/2025
FacilityType	Waiver

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