11D2030052 CLIA NUMBER - HEALTHQWEST FRONTIERS, LLC

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Laboratory Demographics

CLIA Number: 11D2030052

Facility Name: HEALTHQWEST FRONTIERS, LLC

Facility Address:
6707 FOREST PARK DRIVE
SAVANNAH, GA
ZIP 31406
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Facility Phone Number: 912 335-1699

Facility Type: Other - O/P NARCOTIC TX FAC

Certificate Type: Waiver

NPI Number: 1447521240

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	11D2030052
LAB Type	Other - O/P NARCOTIC TX FAC
Facility Name	HEALTHQWEST FRONTIERS, LLC
Street	6707 FOREST PARK DRIVE
City	SAVANNAH
State	GA
ZIP	31406
Phone	912 335-1699
CertificateType	4
CertificateEffectiveDate	9/21/2023
CertificateExpirationDate	9/20/2025
FacilityType	Waiver

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