11D1002962 CLIA NUMBER - EMORY HEALTH CARE ANTICOAGULATION

Laboratory Demographics

CLIA Number: 11D1002962

Facility Name: EMORY HEALTH CARE ANTICOAGULATION

Facility Address:
1525 CLIFTON ROAD NORTH EAST 3RD FLOOR
ATLANTA, GA
ZIP 30322
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Facility Phone Number: 404 778-4451

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1205939691

Taxonomy: 363AS0400X - Physician Assistant

CLIA Record

Field Name	Field Value
CLIA Number	11D1002962
LAB Type	Physician Office
Facility Name	EMORY HEALTH CARE ANTICOAGULATION
Street	1525 CLIFTON ROAD NORTH EAST 3RD FLOOR
City	ATLANTA
State	GA
ZIP	30322
Phone	404 778-4451
CertificateType	4
CertificateEffectiveDate	8/20/2022
CertificateExpirationDate	8/19/2024
FacilityType	Waiver

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