11D1097239 CLIA NUMBER - WESTSIDE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D1097239
  • Facility Name: WESTSIDE SURGERY CENTER
  • Facility Address: 314 WESTSIDE DRIVE
    DOUGLAS, GA
    ZIP 31533
  • Facility Phone: 912 384-2200
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GEORGE H. LIVERMORE III
  • NPI Number: 1013158948
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1097239
LAB Type Ambulatory Surgery Center
Facility Name WESTSIDE SURGERY CENTER
Street 314 WESTSIDE DRIVE
City DOUGLAS
State GA
ZIP 31533
Phone 912 384-2200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Ambulatory Surgery Center
Lab Director GEORGE H. LIVERMORE III

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