11D1089302 CLIA NUMBER - EPS SURGICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 11D1089302
  • Facility Name: EPS SURGICAL CENTER LLC
  • Facility Address: 1457 SCOTT BOULEVARD
    DECATUR, GA
    ZIP 30030
  • Facility Phone: 404 292-2500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: AJEET DHINGRA
  • NPI Number: 1922262278
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1089302
LAB Type Ambulatory Surgery Center
Facility Name EPS SURGICAL CENTER LLC
Street 1457 SCOTT BOULEVARD
City DECATUR
State GA
ZIP 30030
Phone 404 292-2500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Ambulatory Surgery Center
Lab Director AJEET DHINGRA

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This page was last updated on: 3/20/2025