11D1094215 CLIA NUMBER - GEORGIA UROLOGY PA ROCKDALE AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D1094215
  • Facility Name: GEORGIA UROLOGY PA ROCKDALE AMBULATORY SURGERY CENTER
  • Facility Address: 1301 SIGMAN ROAD, SUITE 260
    CONYERS, GA
    ZIP 30012
  • Facility Phone: 770 760-9900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ALLEN FUTRAL
  • NPI Number: 1629222815
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1094215
LAB Type Ambulatory Surgery Center
Facility Name GEORGIA UROLOGY PA ROCKDALE AMBULATORY SURGERY CENTER
Street 1301 SIGMAN ROAD, SUITE 260
City CONYERS
State GA
ZIP 30012
Phone 770 760-9900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Ambulatory Surgery Center
Lab Director ALLEN FUTRAL

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