11D1087581 CLIA NUMBER - WEST CARE GEORGIA

Laboratory Demographics

CLIA Code: 11D1087581
Facility Name: WEST CARE GEORGIA
Facility Address: 827 PRYOR STREET
ATLANTA, GA
ZIP 30315
Facility Phone: 404 761-7485
Facility Type: Comp. Outpatient Rehab Facility
Facility Type: Waiver
Lab Director: JEANNIE LEWIS
NPI Number: 1194942649
Taxonomy: 322D00000X - Residential Treatment Facility, Emotionally Disturbed Children

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CLIA Record

Field Name	Field Value
CLIA Number	11D1087581
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	WEST CARE GEORGIA
Street	827 PRYOR STREET
City	ATLANTA
State	GA
ZIP	30315
Phone	404 761-7485
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/7/2024
Certificate Expiration Date	8/6/2026
Facility Type	Comp. Outpatient Rehab Facility
Lab Director	JEANNIE LEWIS

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