11D1056052 CLIA NUMBER - ALPHACARE MEDICAL CENTER

Laboratory Demographics

CLIA Number: 11D1056052

Facility Name: ALPHACARE MEDICAL CENTER

Facility Address:
1865 LOCKEWAY DRIVE, SUITE 603
ALPHARETTA, GA
ZIP 30004
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Facility Phone Number: 770 752-8499

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1578530325

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D1056052
LAB Type	Physician Office
Facility Name	ALPHACARE MEDICAL CENTER
Street	1865 LOCKEWAY DRIVE, SUITE 603
City	ALPHARETTA
State	GA
ZIP	30004
Phone	770 752-8499
CertificateType	4
CertificateEffectiveDate	7/5/2022
CertificateExpirationDate	7/4/2024
FacilityType	Waiver

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