11D2006163 CLIA NUMBER - ESSENTIAL MEDICAL CARE

Laboratory Demographics

  • CLIA Code: 11D2006163
  • Facility Name: ESSENTIAL MEDICAL CARE
  • Facility Address: 5100 OLD BILL COOK ROAD
    COLLEGE PARK, GA
    ZIP 30349
  • Facility Phone: 678 519-2872
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VICKIE A. JAMES
  • NPI Number: 1932721784
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 11D2006163
LAB Type Physician Office
Facility Name ESSENTIAL MEDICAL CARE
Street 5100 OLD BILL COOK ROAD
City COLLEGE PARK
State GA
ZIP 30349
Phone 678 519-2872
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Physician Office
Lab Director VICKIE A. JAMES

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