11D2017910 CLIA NUMBER - CPMSC ROSWELL, PC

Laboratory Demographics

  • CLIA Code: 11D2017910
  • Facility Name: CPMSC ROSWELL, PC
  • Facility Address: 1295 HEMBREE ROAD, SUITE 101A
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: (404) 920-4950
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: IKENNA OKPAREKE
  • NPI Number: 1356672919
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2017910
LAB Type Ambulatory Surgery Center
Facility Name CPMSC ROSWELL, PC
Street 1295 HEMBREE ROAD, SUITE 101A
City ROSWELL
State GA
ZIP 30076
Phone 4049204950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Ambulatory Surgery Center
Lab Director IKENNA OKPAREKE

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This page was last updated on: 5/18/2026