11D2243026 CLIA NUMBER - REJUVENANT FAMILY HEALTH CARE

Laboratory Demographics

CLIA Number: 11D2243026

Facility Name: REJUVENANT FAMILY HEALTH CARE

Facility Address:
2140 RIVERSIDE DRIVE SUITE C
MACON, GA
ZIP 31204
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Facility Phone Number: 478 309-5500

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164280384

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	11D2243026
LAB Type	Physician Office
Facility Name	REJUVENANT FAMILY HEALTH CARE
Street	2140 RIVERSIDE DRIVE SUITE C
City	MACON
State	GA
ZIP	31204
Phone	478 309-5500
CertificateType	4
CertificateEffectiveDate	11/16/2023
CertificateExpirationDate	11/15/2025
FacilityType	Waiver

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