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11D1031801 CLIA NUMBER - INTERNAL MEDICINE AND GERIATRICS OF HOUSTON LLC

Laboratory Demographics

CLIA Number: 11D1031801

Facility Name: INTERNAL MEDICINE AND GERIATRICS OF HOUSTON LLC

Facility Address:
1743 WATSON BOULEVARD SUITE A
WARNER ROBINS, GA
ZIP 31093
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Facility Phone Number: 478 328-9690

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1730385402

Taxonomy: 207RG0300X - Internal Medicine
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

CLIA Record

Field Name Field Value
CLIA Number 11D1031801
LAB Type Physician Office
Facility Name INTERNAL MEDICINE AND GERIATRICS OF HOUSTON LLC
Street 1743 WATSON BOULEVARD SUITE A
City WARNER ROBINS
State GA
ZIP 31093
Phone 478 328-9690
CertificateType 4
CertificateEffectiveDate 10/12/2022
CertificateExpirationDate 10/11/2024
FacilityType Waiver

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