11D2071580 CLIA NUMBER - WATKINS PERSONAL CARE

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Laboratory Demographics

CLIA Number: 11D2071580

Facility Name: WATKINS PERSONAL CARE

Facility Address:
1939 ISAAC WATKINS ROAD
MONTROSE, GA
ZIP 31065
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Facility Phone Number: 478 676-4646

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1104041367

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	11D2071580
LAB Type	Assisted Living Facility
Facility Name	WATKINS PERSONAL CARE
Street	1939 ISAAC WATKINS ROAD
City	MONTROSE
State	GA
ZIP	31065
Phone	478 676-4646
CertificateType	4
CertificateEffectiveDate	1/15/2024
CertificateExpirationDate	1/14/2026
FacilityType	Waiver

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