11D2197945 CLIA NUMBER - REJUVENATE U WELLNESS CLINIC

Laboratory Demographics

  • CLIA Code: 11D2197945
  • Facility Name: REJUVENATE U WELLNESS CLINIC
  • Facility Address: 5755 NORTH POINT PARKWAY, SUITE 250
    ALPHARETTA, GA
    ZIP 30022
  • Facility Phone: 678 979-3905
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MELISSA R. PAULINE
  • NPI Number: 1205459161
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D2197945
LAB Type Practitioner Other
Facility Name REJUVENATE U WELLNESS CLINIC
Street 5755 NORTH POINT PARKWAY, SUITE 250
City ALPHARETTA
State GA
ZIP 30022
Phone 678 979-3905
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Practitioner Other
Lab Director MELISSA R. PAULINE

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