11D2121197 CLIA NUMBER - PEACHTREE IMMEDIATE CARE - OAK

Laboratory Demographics

  • CLIA Code: 11D2121197
  • Facility Name: PEACHTREE IMMEDIATE CARE - OAK
  • Facility Address: 3885 MUNDY MILL ROAD, #114
    OAKWOOD, GA
    ZIP 30566
  • Facility Phone: 678 971-1892
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES YOST
  • NPI Number: 1982190039
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2121197
LAB Type Physician Office
Facility Name PEACHTREE IMMEDIATE CARE - OAK
Street 3885 MUNDY MILL ROAD, #114
City OAKWOOD
State GA
ZIP 30566
Phone 678 971-1892
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Physician Office
Lab Director JAMES YOST

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This page was last updated on: 9/29/2025