11D2071475 CLIA NUMBER - BLACK BEAR TREATMENT CENTER, LLC

Laboratory Demographics

  • CLIA Code: 11D2071475
  • Facility Name: BLACK BEAR TREATMENT CENTER, LLC
  • Facility Address: 310 BLACK BEAR RIDGE
    SAUTEE NACOOCHEE, GA
    ZIP 30571
  • Facility Phone: 470 539-6903
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DENISE WORKMAN
  • NPI Number: 1558788802
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D2071475
LAB Type Physician Office
Facility Name BLACK BEAR TREATMENT CENTER, LLC
Street 310 BLACK BEAR RIDGE
City SAUTEE NACOOCHEE
State GA
ZIP 30571
Phone 470 539-6903
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2024
Certificate Expiration Date 11/23/2026
Facility Type Physician Office
Lab Director DENISE WORKMAN

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This page was last updated on: 9/29/2025