11D2004718 CLIA NUMBER - AUGUSTA PLASTIC SURGERY CENTER, INC

Laboratory Demographics

  • CLIA Code: 11D2004718
  • Facility Name: AUGUSTA PLASTIC SURGERY CENTER, INC
  • Facility Address: 569 FURYS FERRY ROAD
    MARTINEZ, GA
    ZIP 30907
  • Facility Phone: 706 724-5611
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MR. CHRISTOPHER J. EWART
  • NPI Number: 1013990308
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2004718
LAB Type Ambulatory Surgery Center
Facility Name AUGUSTA PLASTIC SURGERY CENTER, INC
Street 569 FURYS FERRY ROAD
City MARTINEZ
State GA
ZIP 30907
Phone 706 724-5611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Ambulatory Surgery Center
Lab Director MR. CHRISTOPHER J. EWART

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