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11D2253532 CLIA NUMBER - CENTERWELL SENIOR PRIMARY CARE - WESLEY CHAPEL

Laboratory Demographics

CLIA Number: 11D2253532

Facility Name: CENTERWELL SENIOR PRIMARY CARE - WESLEY CHAPEL

Facility Address:
2389 WESLEY CHAPEL ROAD, SUITE 102 ATTN CENTER ADMINISTRATOR
ATLANTA, GA
ZIP 30335
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Facility Phone Number: 404 469-9867

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1689241259

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 11D2253532
LAB Type Physician Office
Facility Name CENTERWELL SENIOR PRIMARY CARE - WESLEY CHAPEL
Street 2389 WESLEY CHAPEL ROAD, SUITE 102 ATTN CENTER ADMINISTRATOR
City ATLANTA
State GA
ZIP 30335
Phone 404 469-9867
CertificateType 4
CertificateEffectiveDate 2/22/2024
CertificateExpirationDate 2/21/2026
FacilityType Waiver

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