11D1098183 CLIA NUMBER - GEORGIA RETINA SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 11D1098183
  • Facility Name: GEORGIA RETINA SURGERY CENTER LLC
  • Facility Address: 1100 JOHNSON FERRY ROAD, SUITE 593
    ATLANTA, GA
    ZIP 30342
  • Facility Phone: 404 574-4475
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DANIEL T. BLAIR
  • NPI Number: 1831730282
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1098183
LAB Type Ambulatory Surgery Center
Facility Name GEORGIA RETINA SURGERY CENTER LLC
Street 1100 JOHNSON FERRY ROAD, SUITE 593
City ATLANTA
State GA
ZIP 30342
Phone 404 574-4475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Ambulatory Surgery Center
Lab Director DANIEL T. BLAIR

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