11D0974720 CLIA NUMBER - SURGERY CENTER OF ROME

Laboratory Demographics

  • CLIA Code: 11D0974720
  • Facility Name: SURGERY CENTER OF ROME
  • Facility Address: 16 JOHN MADDOX DRIVE
    ROME, GA
    ZIP 30165
  • Facility Phone: 706 802-3727
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. JONATHAN WURL
  • NPI Number: 1275597056
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0974720
LAB Type Ambulatory Surgery Center
Facility Name SURGERY CENTER OF ROME
Street 16 JOHN MADDOX DRIVE
City ROME
State GA
ZIP 30165
Phone 706 802-3727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. JONATHAN WURL

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