11D2086226 CLIA NUMBER - TO OUR SHORES, INC

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Laboratory Demographics

CLIA Number: 11D2086226

Facility Name: TO OUR SHORES, INC

Facility Address:
250 LANGLEY DRIVE, SUITE #1101
LAWRENCEVILLE, GA
ZIP 30046
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Facility Phone Number: 770 954-5997

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1639749054

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2086226
LAB Type	Community Clinic
Facility Name	TO OUR SHORES, INC
Street	250 LANGLEY DRIVE, SUITE #1101
City	LAWRENCEVILLE
State	GA
ZIP	30046
Phone	770 954-5997
CertificateType	4
CertificateEffectiveDate	10/29/2022
CertificateExpirationDate	10/28/2024
FacilityType	Waiver

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