11D2157987 CLIA NUMBER - PEACHTREE ALLERGY AND ASTHMA CLINIC, PC

Laboratory Demographics

CLIA Number: 11D2157987

Facility Name: PEACHTREE ALLERGY AND ASTHMA CLINIC, PC

Facility Address:
1800 PEACHTREE STREET, NW, SUITE 720
ATLANTA, GA
ZIP 30309
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Facility Phone Number: 404 351-7520

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1811035652

Taxonomy: 207KA0200X - Allergy & Immunology
A physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	11D2157987
LAB Type	Physician Office
Facility Name	PEACHTREE ALLERGY AND ASTHMA CLINIC, PC
Street	1800 PEACHTREE STREET, NW, SUITE 720
City	ATLANTA
State	GA
ZIP	30309
Phone	404 351-7520
CertificateType	4
CertificateEffectiveDate	11/19/2022
CertificateExpirationDate	11/18/2024
FacilityType	Waiver

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