11D2117647 CLIA NUMBER - SERENITY GROVE

Laboratory Demographics

CLIA Number: 11D2117647

Facility Name: SERENITY GROVE

Facility Address:
315 NEWTON BRIDGE ROAD
ATHENS, GA
ZIP 30607
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Facility Phone Number: 706 389-5157

Facility Type: Other - IOP & ADDICTION TREATENT

Certificate Type: Waiver

NPI Number: 1811442312

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	11D2117647
LAB Type	Other - IOP & ADDICTION TREATENT
Facility Name	SERENITY GROVE
Street	315 NEWTON BRIDGE ROAD
City	ATHENS
State	GA
ZIP	30607
Phone	706 389-5157
CertificateType	4
CertificateEffectiveDate	8/19/2022
CertificateExpirationDate	8/18/2024
FacilityType	Waiver

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