Healther Providers Data Logo

11D2145565 CLIA NUMBER - EVERGREEN PRIMARY CARE AND WELLNESS, PC

Laboratory Demographics

CLIA Number: 11D2145565

Facility Name: EVERGREEN PRIMARY CARE AND WELLNESS, PC

Facility Address:
2450 ATLANTA HWY, SUITE 803
CUMMING, GA
ZIP 30040
Get Directions

Facility Phone Number: 470 253-7944

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1285134999

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 11D2145565
LAB Type Physician Office
Facility Name EVERGREEN PRIMARY CARE AND WELLNESS, PC
Street 2450 ATLANTA HWY, SUITE 803
City CUMMING
State GA
ZIP 30040
Phone 470 253-7944
CertificateType 4
CertificateEffectiveDate 3/12/2024
CertificateExpirationDate 3/11/2026
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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