11D2144705 CLIA NUMBER - MEDLINK LAWRENCEVILLE

Laboratory Demographics

CLIA Number: 11D2144705

Facility Name: MEDLINK LAWRENCEVILLE

Facility Address:
980 LAWRENCEVILLE HIGHWAY
LAWRENCEVILLE, GA
ZIP 30046
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Facility Phone Number: 770 676-6500

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1649829532

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2144705
LAB Type	Federally Qualified Health Center
Facility Name	MEDLINK LAWRENCEVILLE
Street	980 LAWRENCEVILLE HIGHWAY
City	LAWRENCEVILLE
State	GA
ZIP	30046
Phone	770 676-6500
CertificateType	3
CertificateEffectiveDate	2/22/2024
CertificateExpirationDate	2/21/2026
FacilityType	PPMP

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