11D1010600 CLIA NUMBER - AZALEA SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D1010600
  • Facility Name: AZALEA SURGERY CENTER
  • Facility Address: 2810 NORTH OAK STREET
    VALDOSTA, GA
    ZIP 31602
  • Facility Phone: 229 259-0019
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BRIDGETT MOORE
  • NPI Number: 1467664268
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1010600
LAB Type Ambulatory Surgery Center
Facility Name AZALEA SURGERY CENTER
Street 2810 NORTH OAK STREET
City VALDOSTA
State GA
ZIP 31602
Phone 229 259-0019
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Ambulatory Surgery Center
Lab Director BRIDGETT MOORE

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