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11D2080808 CLIA NUMBER - MY DOCTORS CLINIC, LLC D/B/A PEACH CLINIC

Laboratory Demographics

CLIA Number: 11D2080808

Facility Name: MY DOCTORS CLINIC, LLC D/B/A PEACH CLINIC

Facility Address:
3030 OLD ATLANTA RD, SUITE 500
CUMMING, GA
ZIP 30041
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Facility Phone Number: 770 203-2000

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1497183941

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 11D2080808
LAB Type Physician Office
Facility Name MY DOCTORS CLINIC, LLC D/B/A PEACH CLINIC
Street 3030 OLD ATLANTA RD, SUITE 500
City CUMMING
State GA
ZIP 30041
Phone 770 203-2000
CertificateType 4
CertificateEffectiveDate 7/15/2022
CertificateExpirationDate 7/14/2024
FacilityType Waiver

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