11D1086147 CLIA NUMBER - RENUE PLASTIC SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 11D1086147
  • Facility Name: RENUE PLASTIC SURGERY CENTER LLC
  • Facility Address: 2500 STARLING STREET, 604
    BRUNSWICK, GA
    ZIP 31520
  • Facility Phone: 912 280-9977
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CHARLES WILLIAM MITCHELL
  • NPI Number: 1881609543
  • Taxonomy: 2086S0122X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D1086147
LAB Type Ambulatory Surgery Center
Facility Name RENUE PLASTIC SURGERY CENTER LLC
Street 2500 STARLING STREET, 604
City BRUNSWICK
State GA
ZIP 31520
Phone 912 280-9977
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2024
Certificate Expiration Date 7/6/2026
Facility Type Ambulatory Surgery Center
Lab Director CHARLES WILLIAM MITCHELL

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