11D2039155 CLIA NUMBER - PHYSICIANS EXPRESS CARE, LLC

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Laboratory Demographics

CLIA Number: 11D2039155

Facility Name: PHYSICIANS EXPRESS CARE, LLC

Facility Address:
11705 JONES BRIDGE ROAD, SUITE A 201
ALPHARETTA, GA
ZIP 30005
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Facility Phone Number: 770 772-1830

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1487046603

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2039155
LAB Type	Other - URGENT CARE
Facility Name	PHYSICIANS EXPRESS CARE, LLC
Street	11705 JONES BRIDGE ROAD, SUITE A 201
City	ALPHARETTA
State	GA
ZIP	30005
Phone	770 772-1830
CertificateType	4
CertificateEffectiveDate	4/3/2024
CertificateExpirationDate	4/2/2026
FacilityType	Waiver

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