11D2077958 CLIA NUMBER - AMINA MEDICAL CONSULTANTS, PC

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Laboratory Demographics

CLIA Number: 11D2077958

Facility Name: AMINA MEDICAL CONSULTANTS, PC

Facility Address:
2840 NE EXPRESSWAY STE 116
ATLANTA, GA
ZIP 30345
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Facility Phone Number: 404 929-1402

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780083188

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2077958
LAB Type	Physician Office
Facility Name	AMINA MEDICAL CONSULTANTS, PC
Street	2840 NE EXPRESSWAY STE 116
City	ATLANTA
State	GA
ZIP	30345
Phone	404 929-1402
CertificateType	4
CertificateEffectiveDate	5/20/2022
CertificateExpirationDate	5/19/2024
FacilityType	Waiver

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