11D2028835 CLIA NUMBER - LANE DERMATOLOGIC SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 11D2028835
  • Facility Name: LANE DERMATOLOGIC SURGERY CENTER, LLC
  • Facility Address: 1210 BROOKSTONE CENTRE PARKWAY, SUITE B
    COLUMBUS, GA
    ZIP 31904
  • Facility Phone: (706) 322-1717
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOSHUA EDWARD LANE
  • NPI Number: 1538919758
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 11D2028835
LAB Type Ambulatory Surgery Center
Facility Name LANE DERMATOLOGIC SURGERY CENTER, LLC
Street 1210 BROOKSTONE CENTRE PARKWAY, SUITE B
City COLUMBUS
State GA
ZIP 31904
Phone 7063221717
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Ambulatory Surgery Center
Lab Director JOSHUA EDWARD LANE

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