11D2299752 CLIA NUMBER - SERENITY CARE CENTER AND SPA LLC

Laboratory Demographics

CLIA Number: 11D2299752

Facility Name: SERENITY CARE CENTER AND SPA LLC

Facility Address:
305 CENTENNIAL OLYMPIC PARK DRIVE NW SUITE 2733
ATLANTA, GA
ZIP 30313
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Facility Phone Number: 843 609-6169

Facility Type: Other - TELEMEDICINE CLINIC

Certificate Type: Waiver

NPI Number: 1588427637

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2299752
LAB Type	Other - TELEMEDICINE CLINIC
Facility Name	SERENITY CARE CENTER AND SPA LLC
Street	305 CENTENNIAL OLYMPIC PARK DRIVE NW SUITE 2733
City	ATLANTA
State	GA
ZIP	30313
Phone	843 609-6169
CertificateType	4
CertificateEffectiveDate	2/27/2024
CertificateExpirationDate	2/26/2026
FacilityType	Waiver

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