11D2265496 CLIA NUMBER - CHARLIE'S NURSING ANGELS, LLC

Laboratory Demographics

CLIA Number: 11D2265496

Facility Name: CHARLIE'S NURSING ANGELS, LLC

Facility Address:
2692 HARRIS STREET, STE 110
ATLANTA, GA
ZIP 30344
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Facility Phone Number: 404 709-2116

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1295487031

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name	Field Value
CLIA Number	11D2265496
LAB Type	Home Health Agency
Facility Name	CHARLIE'S NURSING ANGELS, LLC
Street	2692 HARRIS STREET, STE 110
City	ATLANTA
State	GA
ZIP	30344
Phone	404 709-2116
CertificateType	4
CertificateEffectiveDate	7/28/2022
CertificateExpirationDate	7/27/2024
FacilityType	Waiver

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