11D2012613 CLIA NUMBER - ORTHOPAEDIC & SPINE SURGERY OF ATLANTA

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Laboratory Demographics

CLIA Number: 11D2012613

Facility Name: ORTHOPAEDIC & SPINE SURGERY OF ATLANTA

Facility Address:
3161 HOWELL MILL ROAD, NW, SUITE 400
ATLANTA, GA
ZIP 30327
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Facility Phone Number: 404 351-5812

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1497954093

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	11D2012613
LAB Type	Physician Office
Facility Name	ORTHOPAEDIC & SPINE SURGERY OF ATLANTA
Street	3161 HOWELL MILL ROAD, NW, SUITE 400
City	ATLANTA
State	GA
ZIP	30327
Phone	404 351-5812
CertificateType	4
CertificateEffectiveDate	7/27/2023
CertificateExpirationDate	7/26/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024