11D0981912 CLIA NUMBER - ROSWELL SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 11D0981912
  • Facility Name: ROSWELL SURGERY CENTER LLC
  • Facility Address: 1285 HEMBREE RD SUITE 200C
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: 770 772-5520
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARK S. MCBRIDE
  • NPI Number: 1720085277
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0981912
LAB Type Ambulatory Surgery Center
Facility Name ROSWELL SURGERY CENTER LLC
Street 1285 HEMBREE RD SUITE 200C
City ROSWELL
State GA
ZIP 30076
Phone 770 772-5520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Ambulatory Surgery Center
Lab Director MARK S. MCBRIDE

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