11D2171238 CLIA NUMBER - TENNET, LLC DBA PRIME TIME PEDIATRICS

Laboratory Demographics

CLIA Number: 11D2171238

Facility Name: TENNET, LLC DBA PRIME TIME PEDIATRICS

Facility Address:
1618 MARS HILL ROAD, SUITE B
WATKINSVILLE, GA
ZIP 30677
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Facility Phone Number: 706 705-4634

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1972149169

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	11D2171238
LAB Type	Physician Office
Facility Name	TENNET, LLC DBA PRIME TIME PEDIATRICS
Street	1618 MARS HILL ROAD, SUITE B
City	WATKINSVILLE
State	GA
ZIP	30677
Phone	706 705-4634
CertificateType	4
CertificateEffectiveDate	8/28/2023
CertificateExpirationDate	8/27/2025
FacilityType	Waiver

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