11D1048669 CLIA NUMBER - GEORGIA CLINIC PC DBA GEORGIA CLINIC AT JOHNS CREEK

Laboratory Demographics

CLIA Number: 11D1048669

Facility Name: GEORGIA CLINIC PC DBA GEORGIA CLINIC AT JOHNS CREEK

Facility Address:
11912 JONES BRIDGE ROAD
ALPHARETTA, GA
ZIP 30005
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Facility Phone Number: 678 957-9600

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1699480368

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	11D1048669
LAB Type	Physician Office
Facility Name	GEORGIA CLINIC PC DBA GEORGIA CLINIC AT JOHNS CREEK
Street	11912 JONES BRIDGE ROAD
City	ALPHARETTA
State	GA
ZIP	30005
Phone	678 957-9600
CertificateType	4
CertificateEffectiveDate	12/7/2023
CertificateExpirationDate	12/6/2025
FacilityType	Waiver

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