11D2022995 CLIA NUMBER - RENUE SURGERY CENTER OF WAYCROSS, LLC

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Laboratory Demographics

CLIA Number: 11D2022995

Facility Name: RENUE SURGERY CENTER OF WAYCROSS, LLC

Facility Address:
1905 TEBEAU STREET
WAYCROSS, GA
ZIP 31501
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Facility Phone Number: 912 280-9977

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1821397654

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2022995
LAB Type	Ambulatory Surgery Center
Facility Name	RENUE SURGERY CENTER OF WAYCROSS, LLC
Street	1905 TEBEAU STREET
City	WAYCROSS
State	GA
ZIP	31501
Phone	912 280-9977
CertificateType	4
CertificateEffectiveDate	4/14/2023
CertificateExpirationDate	4/13/2025
FacilityType	Waiver

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