11D2035977 CLIA NUMBER - NORTHWEST ENT SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 11D2035977
  • Facility Name: NORTHWEST ENT SURGERY CENTER, LLC
  • Facility Address: 960 WOODSTOCK PARKWAY
    WOODSTOCK, GA
    ZIP 30188
  • Facility Phone: 770 427-0368
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. SHATAL L. PARIKH
  • NPI Number: 1932473402
  • Taxonomy: 332S00000X - Hearing Aid Equipment

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CLIA Record

Field Name Field Value
CLIA Number 11D2035977
LAB Type Ambulatory Surgery Center
Facility Name NORTHWEST ENT SURGERY CENTER, LLC
Street 960 WOODSTOCK PARKWAY
City WOODSTOCK
State GA
ZIP 30188
Phone 770 427-0368
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. SHATAL L. PARIKH

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