11D2121702 CLIA NUMBER - PIEDMONT URGENT CARE BY WELLSTREET

Laboratory Demographics

CLIA Number: 11D2121702

Facility Name: PIEDMONT URGENT CARE BY WELLSTREET

Facility Address:
3330 SUGARLOAF PKWY, SUITE A
LAWRENCEVILLE, GA
ZIP 30044
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Facility Phone Number: 678 710-2727

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1093177883

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2121702
LAB Type	Other - URGENT CARE
Facility Name	PIEDMONT URGENT CARE BY WELLSTREET
Street	3330 SUGARLOAF PKWY, SUITE A
City	LAWRENCEVILLE
State	GA
ZIP	30044
Phone	678 710-2727
CertificateType	4
CertificateEffectiveDate	11/14/2022
CertificateExpirationDate	11/13/2024
FacilityType	Waiver

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