11D2026936 CLIA NUMBER - GWINNETT SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 11D2026936
  • Facility Name: GWINNETT SURGERY CENTER, LLC
  • Facility Address: 631 PROFESSIONAL DRIVE, SUITE 390
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 770 338-1666
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KIMBERLY HOLLAND
  • NPI Number: 1396049383
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D2026936
LAB Type Ambulatory Surgery Center
Facility Name GWINNETT SURGERY CENTER, LLC
Street 631 PROFESSIONAL DRIVE, SUITE 390
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 770 338-1666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Ambulatory Surgery Center
Lab Director KIMBERLY HOLLAND

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