11D2296484 CLIA NUMBER - GEORGIA DERMATOLOGY SPECIALISTS OF COWETA CTY, LLC

Laboratory Demographics

CLIA Number: 11D2296484

Facility Name: GEORGIA DERMATOLOGY SPECIALISTS OF COWETA CTY, LLC

Facility Address:
3400 OLD MILTON PKWY, SUITE C 565
ALPHARETTA, GA
ZIP 30005
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Facility Phone Number: 770 664-1012

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1427502202

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	11D2296484
LAB Type	Physician Office
Facility Name	GEORGIA DERMATOLOGY SPECIALISTS OF COWETA CTY, LLC
Street	3400 OLD MILTON PKWY, SUITE C 565
City	ALPHARETTA
State	GA
ZIP	30005
Phone	770 664-1012
CertificateType	3
CertificateEffectiveDate	12/29/2023
CertificateExpirationDate	12/28/2025
FacilityType	PPMP

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