11D2057733 CLIA NUMBER - EYE SURGERY CENTER OF WEST GEORGIA, INC, THE

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Laboratory Demographics

CLIA Number: 11D2057733

Facility Name: EYE SURGERY CENTER OF WEST GEORGIA, INC, THE

Facility Address:
2616 WARMS SPRINGS ROAD, SUITE B
COLUMBUS, GA
ZIP 31904
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Facility Phone Number: 706 507-7654

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1306187554

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2057733
LAB Type	Ambulatory Surgery Center
Facility Name	EYE SURGERY CENTER OF WEST GEORGIA, INC, THE
Street	2616 WARMS SPRINGS ROAD, SUITE B
City	COLUMBUS
State	GA
ZIP	31904
Phone	706 507-7654
CertificateType	4
CertificateEffectiveDate	4/23/2023
CertificateExpirationDate	4/22/2025
FacilityType	Waiver

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