11D1035791 CLIA NUMBER - PETER PING LEE MD PC

Laboratory Demographics

CLIA Number: 11D1035791

Facility Name: PETER PING LEE MD PC

Facility Address:
300 MEDICAL DRIVE, SUITE 701
LAGRANGE, GA
ZIP 30240
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Facility Phone Number: 706 882-0552

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316128457

Taxonomy: 2084N0400X - Psychiatry & Neurology
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

CLIA Record

Field Name	Field Value
CLIA Number	11D1035791
LAB Type	Physician Office
Facility Name	PETER PING LEE MD PC
Street	300 MEDICAL DRIVE, SUITE 701
City	LAGRANGE
State	GA
ZIP	30240
Phone	706 882-0552
CertificateType	4
CertificateEffectiveDate	1/11/2023
CertificateExpirationDate	1/10/2025
FacilityType	Waiver

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