11D2180896 CLIA NUMBER - CHEROKEE CHILD ADVOCACY COUNCIL, INC ANNA CRAWFORD CHILDREN'S CENTER

Laboratory Demographics

CLIA Number: 11D2180896

Facility Name: CHEROKEE CHILD ADVOCACY COUNCIL, INC ANNA CRAWFORD CHILDREN'S CENTER

Facility Address:
9870 HIGHWAY 92, SUITE 200
WOODSTOCK, GA
ZIP 30188
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Facility Phone Number: 678 504-6388

Facility Type: Other - CHILD ADVOCACY CTR

Certificate Type: Waiver

NPI Number: 1740750181

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	11D2180896
LAB Type	Other - CHILD ADVOCACY CTR
Facility Name	CHEROKEE CHILD ADVOCACY COUNCIL, INC ANNA CRAWFORD CHILDREN'S CENTER
Street	9870 HIGHWAY 92, SUITE 200
City	WOODSTOCK
State	GA
ZIP	30188
Phone	678 504-6388
CertificateType	4
CertificateEffectiveDate	3/23/2024
CertificateExpirationDate	3/22/2026
FacilityType	Waiver

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