11D2242010 CLIA NUMBER - DOBBS FAMILY HEALTH AND WELLNESS CENTER

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Laboratory Demographics

CLIA Number: 11D2242010

Facility Name: DOBBS FAMILY HEALTH AND WELLNESS CENTER

Facility Address:
1810 MULKY ROAD, SUITE 200
AUSTELL, GA
ZIP 30106
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Facility Phone Number: 678 402-6970

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1174285043

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	11D2242010
LAB Type	Physician Office
Facility Name	DOBBS FAMILY HEALTH AND WELLNESS CENTER
Street	1810 MULKY ROAD, SUITE 200
City	AUSTELL
State	GA
ZIP	30106
Phone	678 402-6970
CertificateType	4
CertificateEffectiveDate	11/3/2023
CertificateExpirationDate	11/2/2025
FacilityType	Waiver

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