11D2320969 CLIA NUMBER - THRIVE WELLNESS CARE, LLC

Laboratory Demographics

  • CLIA Code: 11D2320969
  • Facility Name: THRIVE WELLNESS CARE, LLC
  • Facility Address: 273 MACLAND ROAD
    DALLAS, GA
    ZIP 30132
  • Facility Phone: 770 414-4001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY R. EVANS
  • NPI Number: 1811795123
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2320969
LAB Type Physician Office
Facility Name THRIVE WELLNESS CARE, LLC
Street 273 MACLAND ROAD
City DALLAS
State GA
ZIP 30132
Phone 770 414-4001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director AMY R. EVANS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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