11D2241390 CLIA NUMBER - ABUNDANT LIFE HEALTHCARE

Laboratory Demographics

CLIA Number: 11D2241390

Facility Name: ABUNDANT LIFE HEALTHCARE

Facility Address:
601A PROFESSIONAL DRIVE SUITE 370
LAWRENCEVILLE, GA
ZIP 30046
Get Directions

Facility Phone Number: 678 869-5145

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1679875173

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	11D2241390
LAB Type	Physician Office
Facility Name	ABUNDANT LIFE HEALTHCARE
Street	601A PROFESSIONAL DRIVE SUITE 370
City	LAWRENCEVILLE
State	GA
ZIP	30046
Phone	678 869-5145
CertificateType	4
CertificateEffectiveDate	10/28/2023
CertificateExpirationDate	10/27/2025
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