11D1009065 CLIA NUMBER - GEORGIA NEUROSURGICAL INSTITUTE PA

Laboratory Demographics

CLIA Number: 11D1009065

Facility Name: GEORGIA NEUROSURGICAL INSTITUTE PA

Facility Address:
840 PINE STREET, SUITE 880
MACON, GA
ZIP 31201
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Facility Phone Number: 478 743-7092

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1972558336

Taxonomy: 207T00000X - Neurological Surgery
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

CLIA Record

Field Name	Field Value
CLIA Number	11D1009065
LAB Type	Physician Office
Facility Name	GEORGIA NEUROSURGICAL INSTITUTE PA
Street	840 PINE STREET, SUITE 880
City	MACON
State	GA
ZIP	31201
Phone	478 743-7092
CertificateType	4
CertificateEffectiveDate	2/5/2023
CertificateExpirationDate	2/4/2025
FacilityType	Waiver

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