11D2125723 CLIA NUMBER - CARECONNECT CONVENIENT CARE

Laboratory Demographics

CLIA Number: 11D2125723

Facility Name: CARECONNECT CONVENIENT CARE

Facility Address:
277 PERRY PARKWAY, SUITE C
PERRY, GA
ZIP 31069
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Facility Phone Number: 478 988-6087

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1659819357

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2125723
LAB Type	Federally Qualified Health Center
Facility Name	CARECONNECT CONVENIENT CARE
Street	277 PERRY PARKWAY, SUITE C
City	PERRY
State	GA
ZIP	31069
Phone	478 988-6087
CertificateType	4
CertificateEffectiveDate	2/13/2023
CertificateExpirationDate	2/12/2025
FacilityType	Waiver

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