11D2010091 CLIA NUMBER - GRIFFIN IMAGING, LLC

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Laboratory Demographics

CLIA Number: 11D2010091

Facility Name: GRIFFIN IMAGING, LLC

Facility Address:
220 ROCK STREET
GRIFFIN, GA
ZIP 30224
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Facility Phone Number: 770 229-4660

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1700199940

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2010091
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	GRIFFIN IMAGING, LLC
Street	220 ROCK STREET
City	GRIFFIN
State	GA
ZIP	30224
Phone	770 229-4660
CertificateType	4
CertificateEffectiveDate	7/20/2022
CertificateExpirationDate	7/19/2024
FacilityType	Waiver

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