11D2197671 CLIA NUMBER - BREASTFEED ATLANTA, LLC

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Laboratory Demographics

CLIA Number: 11D2197671

Facility Name: BREASTFEED ATLANTA, LLC

Facility Address:
1 BALTIMORE PLACE SUITE 160
ATLANTA, GA
ZIP 30308
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Facility Phone Number: 404 454-7152

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558722215

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2197671
LAB Type	Physician Office
Facility Name	BREASTFEED ATLANTA, LLC
Street	1 BALTIMORE PLACE SUITE 160
City	ATLANTA
State	GA
ZIP	30308
Phone	404 454-7152
CertificateType	4
CertificateEffectiveDate	10/27/2022
CertificateExpirationDate	10/26/2024
FacilityType	Waiver

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