11D2270924 CLIA NUMBER - CRABAPPLE MEDICAL CENTER

Laboratory Demographics

CLIA Number: 11D2270924

Facility Name: CRABAPPLE MEDICAL CENTER

Facility Address:
282 RUCKER ROAD, SUITE 140
ALPHARETTA, GA
ZIP 30004
Get Directions

Facility Phone Number: 770 360-9484

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1013248756

Taxonomy: 1223S0112X - Dentist
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

CLIA Record

Field Name	Field Value
CLIA Number	11D2270924
LAB Type	Physician Office
Facility Name	CRABAPPLE MEDICAL CENTER
Street	282 RUCKER ROAD, SUITE 140
City	ALPHARETTA
State	GA
ZIP	30004
Phone	770 360-9484
CertificateType	4
CertificateEffectiveDate	10/25/2022
CertificateExpirationDate	10/24/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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