11D2287771 CLIA NUMBER - NORTH ATLANTA PRIMARY CARE DBA MIDDLE GEORGIA PRIMARY CARE

Laboratory Demographics

CLIA Number: 11D2287771

Facility Name: NORTH ATLANTA PRIMARY CARE DBA MIDDLE GEORGIA PRIMARY CARE

Facility Address:
1115 MORNINGSIDE DRIVE
PERRY, GA
ZIP 31069
Get Directions

Facility Phone Number: 770 442-1911

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558803486

Taxonomy: 363AM0700X - Physician Assistant

CLIA Record

Field Name	Field Value
CLIA Number	11D2287771
LAB Type	Physician Office
Facility Name	NORTH ATLANTA PRIMARY CARE DBA MIDDLE GEORGIA PRIMARY CARE
Street	1115 MORNINGSIDE DRIVE
City	PERRY
State	GA
ZIP	31069
Phone	770 442-1911
CertificateType	4
CertificateEffectiveDate	8/17/2023
CertificateExpirationDate	8/16/2025
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