11D1093631 CLIA NUMBER - PAIN CARE CENTER OF GEORGIA

Laboratory Demographics

  • CLIA Code: 11D1093631
  • Facility Name: PAIN CARE CENTER OF GEORGIA
  • Facility Address: 1365 ROCK QUARRY ROAD
    STOCKBRIDGE, GA
    ZIP 30281
  • Facility Phone: (770) 771-6580
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: VINCENT GALAN
  • NPI Number: 1265607626
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 11D1093631
LAB Type Ambulatory Surgery Center
Facility Name PAIN CARE CENTER OF GEORGIA
Street 1365 ROCK QUARRY ROAD
City STOCKBRIDGE
State GA
ZIP 30281
Phone 7707716580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Ambulatory Surgery Center
Lab Director VINCENT GALAN

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This page was last updated on: 5/18/2026