11D0942019 CLIA NUMBER - GEORGIA BONE AND JOINT SURGEONS PC CENTER FOR ORTHOPEDIC SURGERY

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Laboratory Demographics

CLIA Number: 11D0942019

Facility Name: GEORGIA BONE AND JOINT SURGEONS PC CENTER FOR ORTHOPEDIC SURGERY

Facility Address:
15 MEDICAL DRIVE
CARTERSVILLE, GA
ZIP 30121
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Facility Phone Number: 770 386-5221

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1578748620

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D0942019
LAB Type	Physician Office
Facility Name	GEORGIA BONE AND JOINT SURGEONS PC CENTER FOR ORTHOPEDIC SURGERY
Street	15 MEDICAL DRIVE
City	CARTERSVILLE
State	GA
ZIP	30121
Phone	770 386-5221
CertificateType	4
CertificateEffectiveDate	5/14/2023
CertificateExpirationDate	5/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024