11D2297801 CLIA NUMBER - PRESBYTERIAN VILLAGE-PIEDMONT

Laboratory Demographics

CLIA Number: 11D2297801

Facility Name: PRESBYTERIAN VILLAGE-PIEDMONT

Facility Address:
1400 LIVE OAK LANE, BLDG 100
ATHENS, GA
ZIP 30606
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Facility Phone Number: 706 769-3331

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1346830270

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	11D2297801
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	PRESBYTERIAN VILLAGE-PIEDMONT
Street	1400 LIVE OAK LANE, BLDG 100
City	ATHENS
State	GA
ZIP	30606
Phone	706 769-3331
CertificateType	4
CertificateEffectiveDate	1/23/2024
CertificateExpirationDate	1/22/2026
FacilityType	Waiver

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