11D1046694 CLIA NUMBER - GEORGIA HARM REDUCTION COALITION BENNETT CENTER

Laboratory Demographics

  • CLIA Code: 11D1046694
  • Facility Name: GEORGIA HARM REDUCTION COALITION BENNETT CENTER
  • Facility Address: 1231 JOSEPH E BOONE BOULEVARDD
    ATLANTA, GA
    ZIP 30314
  • Facility Phone: 404 817-9994
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MOJGAN Y. ZARE
  • NPI Number: 1316404767
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1046694
LAB Type Practitioner Other
Facility Name GEORGIA HARM REDUCTION COALITION BENNETT CENTER
Street 1231 JOSEPH E BOONE BOULEVARDD
City ATLANTA
State GA
ZIP 30314
Phone 404 817-9994
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2023
Certificate Expiration Date 10/16/2025
Facility Type Practitioner Other
Lab Director MOJGAN Y. ZARE

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This page was last updated on: 3/20/2025