SHAW FAMILY HEALTH CENTER PLANT WD
NPI 1174154496
Clinic/Center - Multi-Specialty in Dalton, GA

Q: What is Premise Health Of Georgia Medical, P.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Active since January 27, 2020CLIA 11D2069045 · Waiver

2305 ABUTMENT RD, DALTON, GA 30721(706) 532-2588(706) 532-2589 Get Directions Write a Review

NPPES record last updated: August 24, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 24, 2022, Jan 27, 2020 (2 updates tracked since 2020).

On this page

About Shaw Family Health Center Plant Wd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAW FAMILY HEALTH CENTER PLANT WD (NPI 1174154496) is a healthcare organization registered as a multi-specialty in Dalton, Georgia and active in the NPI registry since January 2020. The organization holds a CLIA Waiver certificate valid through June 10, 2027 and lists Jon Leizman, President, as its authorized official.

NPPES Registry Identity

NPI1174154496

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NamePREMISE HEALTH OF GEORGIA MEDICAL, P.C.

Location Address2305 ABUTMENT RDDalton, GA 30721-4881

Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993

Phone(706) 532-2588

Fax(706) 532-2589

Organization SubpartNo

Authorized OfficialJon LeizmanPresident · (216) 479-9063

Enumeration DateJanuary 27, 2020

Last NPPES UpdateAugust 24, 20222 updates tracked since enumeration

NPPES CertifiedAugust 24, 2022

✔ NPI 1174154496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

2305 ABUTMENT RD, Dalton, GA 30721

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Other Names 1

Doing Business AsShaw Family Health Center Plant Wd

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2069045

Premise Health Of Georgia Medical, PC · Dalton, GA

Active · expires Jun 10, 2027

CLIA Number11D2069045

Laboratory TypePhysician Office

Certificate Effective DateJune 11, 2025

Certificate Expiration DateJune 10, 2027

Laboratory DirectorPaul Dassow

Laboratory Phone(706) 609-9960

Laboratory LocationPremise Health Of Georgia Medical, PC2659 Abutment Road, Dalton, GA 30721

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premise Health Of Georgia Medical, P.C.'s NPI number?

The NPI number for Premise Health Of Georgia Medical, P.C. is 1174154496. It was assigned to this organization in the NPPES registry on January 27, 2020. The provider is doing business as Shaw Family Health Center Plant Wd.

Where is Premise Health Of Georgia Medical, P.C. located?

Premise Health Of Georgia Medical, P.C. is located at 2305 Abutment Rd, Dalton, GA 30721. The listed phone number is (706) 532-2588.

What is Premise Health Of Georgia Medical, P.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Premise Health Of Georgia Medical, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2069045) is associated with this NPI, valid through June 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premise Health Of Georgia Medical, P.C. was last updated on August 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.