11D1041568 CLIA NUMBER - CAPITAL HEALTHCARE MSO INC DBA ALLCARE BUCKHEAD

Laboratory Demographics

  • CLIA Code: 11D1041568
  • Facility Name: CAPITAL HEALTHCARE MSO INC DBA ALLCARE BUCKHEAD
  • Facility Address: 4605 ROSWELL ROAD
    ATLANTA, GA
    ZIP 30342
  • Facility Phone: 304 312-3281
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HEATHER ELSNER BOLDT
  • NPI Number: 1972080554
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1041568
LAB Type Physician Office
Facility Name CAPITAL HEALTHCARE MSO INC DBA ALLCARE BUCKHEAD
Street 4605 ROSWELL ROAD
City ATLANTA
State GA
ZIP 30342
Phone 304 312-3281
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Physician Office
Lab Director HEATHER ELSNER BOLDT

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This page was last updated on: 9/29/2025