11D1090505 CLIA NUMBER - ATL COLORECTAL SURGERY PC

Laboratory Demographics

  • CLIA Code: 11D1090505
  • Facility Name: ATL COLORECTAL SURGERY PC
  • Facility Address: 95 COLLIER ROAD NW SUITE 4025
    ATLANTA, GA
    ZIP 30309
  • Facility Phone: 404 574-5820
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SWETHA K. RAMAKRISHNAN
  • NPI Number: 1316146483
  • Taxonomy: 208C00000X - Colon & Rectal Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D1090505
LAB Type Physician Office
Facility Name ATL COLORECTAL SURGERY PC
Street 95 COLLIER ROAD NW SUITE 4025
City ATLANTA
State GA
ZIP 30309
Phone 404 574-5820
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/16/2025
Certificate Expiration Date 2/15/2027
Facility Type Physician Office
Lab Director SWETHA K. RAMAKRISHNAN

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