11D2125729 CLIA NUMBER - AMERICAN HEALTH IMAGING OF HIRAM

Laboratory Demographics

CLIA Number: 11D2125729

Facility Name: AMERICAN HEALTH IMAGING OF HIRAM

Facility Address:
4374 ATLANTA HIGHWAY, SUITE 125
HIRAM, GA
ZIP 30141
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Facility Phone Number: 678 941-1777

Facility Type: Independent

Certificate Type: Waiver

NPI Number: 1700445582

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2125729
LAB Type	Independent
Facility Name	AMERICAN HEALTH IMAGING OF HIRAM
Street	4374 ATLANTA HIGHWAY, SUITE 125
City	HIRAM
State	GA
ZIP	30141
Phone	678 941-1777
CertificateType	4
CertificateEffectiveDate	3/8/2024
CertificateExpirationDate	3/7/2026
FacilityType	Waiver

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