11D0254935 CLIA NUMBER - MARIETTA SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D0254935
  • Facility Name: MARIETTA SURGICAL CENTER
  • Facility Address: 780 CANTON ROAD SUITE 100
    MARIETTA, GA
    ZIP 30060
  • Facility Phone: 770 422-1579
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: HERSH CHOPRA
  • NPI Number: 1669437109
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0254935
LAB Type Ambulatory Surgery Center
Facility Name MARIETTA SURGICAL CENTER
Street 780 CANTON ROAD SUITE 100
City MARIETTA
State GA
ZIP 30060
Phone 770 422-1579
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ambulatory Surgery Center
Lab Director HERSH CHOPRA

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