11D2192206 CLIA NUMBER - LAKEVIEW BEHAVIORAL HEALTH OUTPATIENT CLINIC

Laboratory Demographics

  • CLIA Code: 11D2192206
  • Facility Name: LAKEVIEW BEHAVIORAL HEALTH OUTPATIENT CLINIC
  • Facility Address: 3294 MEDLOCK BRIDGE ROAD
    NORCROSS, GA
    ZIP 30092
  • Facility Phone: 706 621-6249
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: DEAGAN WATSON
  • NPI Number: 1174865513
  • Taxonomy: 283Q00000X - Psychiatric Hospital

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CLIA Record

Field Name Field Value
CLIA Number 11D2192206
LAB Type Comp. Outpatient Rehab Facility
Facility Name LAKEVIEW BEHAVIORAL HEALTH OUTPATIENT CLINIC
Street 3294 MEDLOCK BRIDGE ROAD
City NORCROSS
State GA
ZIP 30092
Phone 706 621-6249
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2024
Certificate Expiration Date 9/7/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director DEAGAN WATSON

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This page was last updated on: 9/29/2025