11D2022796 CLIA NUMBER - CPMSC CARROLLTON, LLC

Laboratory Demographics

  • CLIA Code: 11D2022796
  • Facility Name: CPMSC CARROLLTON, LLC
  • Facility Address: 812 SOUTH PARK STREET, SUITE 5 B
    CARROLLTON, GA
    ZIP 30117
  • Facility Phone: 404 920-4950
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DAVID ROSENFELD
  • NPI Number: 1316233612
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2022796
LAB Type Ambulatory Surgery Center
Facility Name CPMSC CARROLLTON, LLC
Street 812 SOUTH PARK STREET, SUITE 5 B
City CARROLLTON
State GA
ZIP 30117
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 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type Ambulatory Surgery Center
Lab Director DAVID ROSENFELD

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