11D2127324 CLIA NUMBER - HOMETOWN FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 11D2127324

Facility Name: HOMETOWN FAMILY MEDICINE

Facility Address:
1698 VERNON ROAD
LAGRANGE, GA
ZIP 30240
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Facility Phone Number: 706 298-4937

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1992153548

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	11D2127324
LAB Type	Physician Office
Facility Name	HOMETOWN FAMILY MEDICINE
Street	1698 VERNON ROAD
City	LAGRANGE
State	GA
ZIP	30240
Phone	706 298-4937
CertificateType	4
CertificateEffectiveDate	3/13/2023
CertificateExpirationDate	3/12/2025
FacilityType	Waiver

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