11D2259357 CLIA NUMBER - FOUR CORNERS TESTING, LLC

Laboratory Demographics

CLIA Number: 11D2259357

Facility Name: FOUR CORNERS TESTING, LLC

Facility Address:
3343 PEACHTREE ROAD, NE, STE 145-2137
ATLANTA, GA
ZIP 30326
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Facility Phone Number: 404 969-2779

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1710693734

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	11D2259357
LAB Type	Mobile Laboratory
Facility Name	FOUR CORNERS TESTING, LLC
Street	3343 PEACHTREE ROAD, NE, STE 145-2137
City	ATLANTA
State	GA
ZIP	30326
Phone	404 969-2779
CertificateType	4
CertificateEffectiveDate	5/5/2022
CertificateExpirationDate	5/4/2024
FacilityType	Waiver

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