11D2204079 CLIA NUMBER - CARL BEAN MEN'S HEALTH AND WELLNESS CENTER

Home > CLIA Lookup > 11D2204079

Laboratory Demographics

CLIA Number: 11D2204079

Facility Name: CARL BEAN MEN'S HEALTH AND WELLNESS CENTER

Facility Address:
2140 MARTIN LUTHER KING JR DRIVE, SW
ATLANTA, GA
ZIP 30310
Get Directions

Facility Phone Number: 404 609-3197

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134775208

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	11D2204079
LAB Type	Physician Office
Facility Name	CARL BEAN MEN'S HEALTH AND WELLNESS CENTER
Street	2140 MARTIN LUTHER KING JR DRIVE, SW
City	ATLANTA
State	GA
ZIP	30310
Phone	404 609-3197
CertificateType	4
CertificateEffectiveDate	12/8/2022
CertificateExpirationDate	12/7/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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