11D2278875 CLIA NUMBER - ESSENTIAL INTERNAL MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 11D2278875
  • Facility Name: ESSENTIAL INTERNAL MEDICINE, LLC
  • Facility Address: 619 RANKIN STREET, NE
    ATLANTA, GA
    ZIP 30308
  • Facility Phone: 404 895-7894
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CATHERINE L. DEKLE
  • NPI Number: 1417829516
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2278875
LAB Type Physician Office
Facility Name ESSENTIAL INTERNAL MEDICINE, LLC
Street 619 RANKIN STREET, NE
City ATLANTA
State GA
ZIP 30308
Phone 404 895-7894
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Physician Office
Lab Director CATHERINE L. DEKLE

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This page was last updated on: 9/29/2025