11D1099266 CLIA NUMBER - CPM SURGERY CENTER 3, LLC

Laboratory Demographics

  • CLIA Code: 11D1099266
  • Facility Name: CPM SURGERY CENTER 3, LLC
  • Facility Address: 3400 CHAPEL HILL ROAD, SUITE 102
    DOUGLASVILLE, GA
    ZIP 30135
  • Facility Phone: 404 920-4950
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: IKENNA OKPAREKE
  • NPI Number: 1669621496
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1099266
LAB Type Ambulatory Surgery Center
Facility Name CPM SURGERY CENTER 3, LLC
Street 3400 CHAPEL HILL ROAD, SUITE 102
City DOUGLASVILLE
State GA
ZIP 30135
Phone 404 920-4950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Ambulatory Surgery Center
Lab Director IKENNA OKPAREKE

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