11D0954036 CLIA NUMBER - MARIETTA PLASTIC SURGERY PC

Laboratory Demographics

  • CLIA Code: 11D0954036
  • Facility Name: MARIETTA PLASTIC SURGERY PC
  • Facility Address: 823 CAMPBELL HILL ST
    MARIETTA, GA
    ZIP 30060
  • Facility Phone: 770 425-0118
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: NANCY TOWNSEND
  • NPI Number: 1164746244
  • Taxonomy: 2086S0122X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D0954036
LAB Type Ambulatory Surgery Center
Facility Name MARIETTA PLASTIC SURGERY PC
Street 823 CAMPBELL HILL ST
City MARIETTA
State GA
ZIP 30060
Phone 770 425-0118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Ambulatory Surgery Center
Lab Director NANCY TOWNSEND

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