11D2081686 CLIA NUMBER - COBBLESTONE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D2081686
  • Facility Name: COBBLESTONE SURGERY CENTER
  • Facility Address: 3450 ACWORTH DUE WEST RD BLDG 200 SUITE 100
    KENNESAW, GA
    ZIP 30144
  • Facility Phone: 770 794-6643
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARCUS H. CRAWFORD
  • NPI Number: 1902213432
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2081686
LAB Type Ambulatory Surgery Center
Facility Name COBBLESTONE SURGERY CENTER
Street 3450 ACWORTH DUE WEST RD BLDG 200 SUITE 100
City KENNESAW
State GA
ZIP 30144
Phone 770 794-6643
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Ambulatory Surgery Center
Lab Director MARCUS H. CRAWFORD

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