11D2033805 CLIA NUMBER - PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER, LLC

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Laboratory Demographics

CLIA Number: 11D2033805

Facility Name: PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER, LLC

Facility Address:
5505 PEACHTREE DUNWOODY ROAD, NE, SUITE 200
ATLANTA, GA
ZIP 30342
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Facility Phone Number: 404 350-2450

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1730463753

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2033805
LAB Type	Ambulatory Surgery Center
Facility Name	PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER, LLC
Street	5505 PEACHTREE DUNWOODY ROAD, NE, SUITE 200
City	ATLANTA
State	GA
ZIP	30342
Phone	404 350-2450
CertificateType	4
CertificateEffectiveDate	12/12/2023
CertificateExpirationDate	12/11/2025
FacilityType	Waiver

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