11D1062430 CLIA NUMBER - TOXICOLOGY ASSOCIATES OF NORTH GEORGIA GWINNETT INCORPORATE

Laboratory Demographics

CLIA Number: 11D1062430

Facility Name: TOXICOLOGY ASSOCIATES OF NORTH GEORGIA GWINNETT INCORPORATE

Facility Address:
751 COLLINS HILL ROAD
LAWRENCEVILLE, GA
ZIP 30046
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Facility Phone Number: 770 248-1616

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1033440805

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	11D1062430
LAB Type	Practitioner Other
Facility Name	TOXICOLOGY ASSOCIATES OF NORTH GEORGIA GWINNETT INCORPORATE
Street	751 COLLINS HILL ROAD
City	LAWRENCEVILLE
State	GA
ZIP	30046
Phone	770 248-1616
CertificateType	4
CertificateEffectiveDate	12/14/2022
CertificateExpirationDate	12/13/2024
FacilityType	Waiver

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