11D1094207 CLIA NUMBER - AESTHETIC SPECIALITY CENTRE

Laboratory Demographics

  • CLIA Code: 11D1094207
  • Facility Name: AESTHETIC SPECIALITY CENTRE
  • Facility Address: 1825 OLD ALABAMA ROAD SUITE 201
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: 770 393-9000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARC E. YUNE
  • NPI Number: 1770520587
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D1094207
LAB Type Physician Office
Facility Name AESTHETIC SPECIALITY CENTRE
Street 1825 OLD ALABAMA ROAD SUITE 201
City ROSWELL
State GA
ZIP 30076
Phone 770 393-9000
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Physician Office
Lab Director MARC E. YUNE

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