11D2066330 CLIA NUMBER - EAST COBB CARDIAC REHABILITATION

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Laboratory Demographics

CLIA Number: 11D2066330

Facility Name: EAST COBB CARDIAC REHABILITATION

Facility Address:
3747 ROSWELL RD NE STE 114 A SERVICE OF WELLSTAR WINDY HILL HOSPITAL
MARIETTA, GA
ZIP 30062
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Facility Phone Number: 470 956-9638

Facility Type: Other - HOSPITAL O/P DEPT

Certificate Type: Waiver

NPI Number: 1184650350

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	11D2066330
LAB Type	Other - HOSPITAL O/P DEPT
Facility Name	EAST COBB CARDIAC REHABILITATION
Street	3747 ROSWELL RD NE STE 114 A SERVICE OF WELLSTAR WINDY HILL HOSPITAL
City	MARIETTA
State	GA
ZIP	30062
Phone	470 956-9638
CertificateType	4
CertificateEffectiveDate	9/25/2023
CertificateExpirationDate	9/24/2025
FacilityType	Waiver

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