11D2069117 CLIA NUMBER - SALUBRIOUS ASC, LLC

Laboratory Demographics

  • CLIA Code: 11D2069117
  • Facility Name: SALUBRIOUS ASC, LLC
  • Facility Address: 240 HERITAGE WALK, SUITE 101 B
    WOODSTOCK, GA
    ZIP 30188
  • Facility Phone: 770 516-7880
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MR. JEFFREY N. RUBIN
  • NPI Number: 1770911463
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2069117
LAB Type Ambulatory Surgery Center
Facility Name SALUBRIOUS ASC, LLC
Street 240 HERITAGE WALK, SUITE 101 B
City WOODSTOCK
State GA
ZIP 30188
Phone 770 516-7880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Ambulatory Surgery Center
Lab Director MR. JEFFREY N. RUBIN

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