11D1092528 CLIA NUMBER - SEASIDE SURGICAL LLC

Laboratory Demographics

  • CLIA Code: 11D1092528
  • Facility Name: SEASIDE SURGICAL LLC
  • Facility Address: 3303 B GLYNN AVENUE
    BRUNSWICK, GA
    ZIP 31520
  • Facility Phone: 912 466-9500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BONNIE J. BROOKS
  • NPI Number: 1780820381
  • Taxonomy: 261QS0132X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1092528
LAB Type Ambulatory Surgery Center
Facility Name SEASIDE SURGICAL LLC
Street 3303 B GLYNN AVENUE
City BRUNSWICK
State GA
ZIP 31520
Phone 912 466-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2024
Certificate Expiration Date 11/25/2026
Facility Type Ambulatory Surgery Center
Lab Director BONNIE J. BROOKS

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