11D2101702 CLIA NUMBER - CARECONNECT CONVENIENT CARE

Laboratory Demographics

CLIA Number: 11D2101702

Facility Name: CARECONNECT CONVENIENT CARE

Facility Address:
101 DELUXE CIRCLE, SUITE B
THOMASTON, GA
ZIP 30286
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Facility Phone Number: 706 647-7509

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1093190670

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2101702
LAB Type	Federally Qualified Health Center
Facility Name	CARECONNECT CONVENIENT CARE
Street	101 DELUXE CIRCLE, SUITE B
City	THOMASTON
State	GA
ZIP	30286
Phone	706 647-7509
CertificateType	4
CertificateEffectiveDate	9/8/2023
CertificateExpirationDate	9/7/2025
FacilityType	Waiver

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