| NAME |
LAWRENCEVILLE CBOC |
| STATE |
GEORGIA |
| STREET ADDR. 1 |
455 PHILIP BLVD STE 200 |
| CITY |
LAWRENCEVILLE |
| ZIP |
30046-8766 |
| OFFICIAL VA NAME |
LAWRENCEVILLE CBOC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
LAWRENCEVILLE VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1780631689
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
508GH |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1780631689
-
- CODING SYSTEM: VASTANUM
- ID: 508GH
-
- CODING SYSTEM: CLIA
- ID: 11D1001681
|
