11D2069285 CLIA NUMBER - COLUMBUS ADDICTION ASSOCIATES, LLC MEDMARK TREATMENT CENTERS COLUMBUS NORTH

Home > CLIA Lookup > 11D2069285

Laboratory Demographics

CLIA Number: 11D2069285

Facility Name: COLUMBUS ADDICTION ASSOCIATES, LLC MEDMARK TREATMENT CENTERS COLUMBUS NORTH

Facility Address:
5617 PRINCETON AVENUE, SUITE B
COLUMBUS, GA
ZIP 31904
Get Directions

Facility Phone Number: 706 257-7722

Facility Type: Other - NAROTIC TREATMENT PROGRAM

Certificate Type: Waiver

NPI Number: 1700244415

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2069285
LAB Type	Other - NAROTIC TREATMENT PROGRAM
Facility Name	COLUMBUS ADDICTION ASSOCIATES, LLC MEDMARK TREATMENT CENTERS COLUMBUS NORTH
Street	5617 PRINCETON AVENUE, SUITE B
City	COLUMBUS
State	GA
ZIP	31904
Phone	706 257-7722
CertificateType	4
CertificateEffectiveDate	11/21/2023
CertificateExpirationDate	11/20/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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