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11D1092802 CLIA NUMBER - AMERICAN HEALTH IMAGING OF LAWRENCEVILLE

Laboratory Demographics

CLIA Number: 11D1092802

Facility Name: AMERICAN HEALTH IMAGING OF LAWRENCEVILLE

Facility Address:
481 W PIKE STREET
LAWRENCEVILLE, GA
ZIP 30046
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Facility Phone Number: 678 376-3550

Facility Type: Independent

Certificate Type: Waiver
NPI Number: 1467437327

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 11D1092802
LAB Type Independent
Facility Name AMERICAN HEALTH IMAGING OF LAWRENCEVILLE
Street 481 W PIKE STREET
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 678 376-3550
CertificateType 4
CertificateEffectiveDate 11/19/2023
CertificateExpirationDate 11/18/2025
FacilityType Waiver

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