11D2174960 CLIA NUMBER - PEACHTREE ALLERGY AND ASTHMA CLINIC, PC

Laboratory Demographics

  • CLIA Code: 11D2174960
  • Facility Name: PEACHTREE ALLERGY AND ASTHMA CLINIC, PC
  • Facility Address: 820 EBENEZER CHURCH ROAD, SUITE 101
    SHARPSBURG, GA
    ZIP 30277
  • Facility Phone: 770 832-7984
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KARI SUEGL
  • NPI Number: 1477208437
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 11D2174960
LAB Type Physician Office
Facility Name PEACHTREE ALLERGY AND ASTHMA CLINIC, PC
Street 820 EBENEZER CHURCH ROAD, SUITE 101
City SHARPSBURG
State GA
ZIP 30277
Phone 770 832-7984
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Physician Office
Lab Director KARI SUEGL

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This page was last updated on: 3/20/2025