11D2132552 CLIA NUMBER - CON ROC INC DBA ROCKDALE HOUSES FOR MEN & WOMEN

Laboratory Demographics

CLIA Number: 11D2132552

Facility Name: CON ROC INC DBA ROCKDALE HOUSES FOR MEN & WOMEN

Facility Address:
1060 SCOTT STREET
CONYERS, GA
ZIP 30012
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Facility Phone Number: 770 483-3984

Facility Type: Other - SUBS ABUSE RECOVERY RESID

Certificate Type: Waiver

NPI Number: 1043352305

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	11D2132552
LAB Type	Other - SUBS ABUSE RECOVERY RESID
Facility Name	CON ROC INC DBA ROCKDALE HOUSES FOR MEN & WOMEN
Street	1060 SCOTT STREET
City	CONYERS
State	GA
ZIP	30012
Phone	770 483-3984
CertificateType	4
CertificateEffectiveDate	6/22/2023
CertificateExpirationDate	6/21/2025
FacilityType	Waiver

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