11D1002447 CLIA NUMBER - WOODSTOCK ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 11D1002447
  • Facility Name: WOODSTOCK ENDOSCOPY CENTER
  • Facility Address: 900 TOWNE LAKE PKWY SUITE 310
    WOODSTOCK, GA
    ZIP 30188
  • Facility Phone: 770 926-5459
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARC D. ROSENBERG
  • NPI Number: 1417477902
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 11D1002447
LAB Type Ambulatory Surgery Center
Facility Name WOODSTOCK ENDOSCOPY CENTER
Street 900 TOWNE LAKE PKWY SUITE 310
City WOODSTOCK
State GA
ZIP 30188
Phone 770 926-5459
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2024
Certificate Expiration Date 8/6/2026
Facility Type Ambulatory Surgery Center
Lab Director MARC D. ROSENBERG

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