Clark Health Services LLC

Organization Active NPI Primary Care Clinic/Center · La Fayette, GA

NPI 1073484879 · NPPES record last updated Apr 1, 2026

Key facts

NPI
1073484879
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
Legal business name
CLARK HEALTH SERVICES LLC
Practice address
106 Pearl Dr Ste 106
La Fayette, GA 30728-7510
Phone
(423) 653-6404
NPI assigned
Sep 15, 2025
Organization subpart
No

Authorized official

Name
Leila Clark, FNP-C
Title
Owner/President
Phone
(423) 653-6404

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2333761Harmony Health Primary Care
106 Pearl Drive, Suite 106, Lafayette, GA 30728
Certificate of waiverNov 9, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20251226000017 GA Part B Supplier - Clinic/Group Practice 9032605225 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, GA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Yes

Addresses

Primary practice location

106 Pearl Dr Ste 106
La Fayette, GA 30728-7510

Mailing address

121 Justin Dr
La Fayette, GA 30728-6974
Phone (423) 653-6404

Other names

  • Harmony Health Primary Care Doing business as

Other providers in La Fayette, GA

All providers in La Fayette, GA · Primary Care Clinic/Center in Georgia

Sources for this page

Verify at the official NPI Registry.