11D1010515 CLIA NUMBER - CONCENTRA - MIDTOWN

Laboratory Demographics

CLIA Number: 11D1010515

Facility Name: CONCENTRA - MIDTOWN

Facility Address:
688 SPRING STREET, NW
ATLANTA, GA
ZIP 30308
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Facility Phone Number: 404 881-1155

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1205028883

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D1010515
LAB Type	Physician Office
Facility Name	CONCENTRA - MIDTOWN
Street	688 SPRING STREET, NW
City	ATLANTA
State	GA
ZIP	30308
Phone	404 881-1155
CertificateType	4
CertificateEffectiveDate	3/14/2023
CertificateExpirationDate	3/13/2025
FacilityType	Waiver

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