11D2269735 CLIA NUMBER - PRIME CARE EMS

Laboratory Demographics

CLIA Number: 11D2269735

Facility Name: PRIME CARE EMS

Facility Address:
7481 SOUTHLAKE PARKWAY SUITE C
MORROW, GA
ZIP 30260
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Facility Phone Number: 404 452-4044

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1861960106

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	11D2269735
LAB Type	Ambulance
Facility Name	PRIME CARE EMS
Street	7481 SOUTHLAKE PARKWAY SUITE C
City	MORROW
State	GA
ZIP	30260
Phone	404 452-4044
CertificateType	4
CertificateEffectiveDate	10/3/2022
CertificateExpirationDate	10/2/2024
FacilityType	Waiver

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