11D2089612 CLIA NUMBER - ROSWELL EYE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D2089612
  • Facility Name: ROSWELL EYE SURGERY CENTER
  • Facility Address: 3775 ROSWELL ROAD SUITE 175
    MARIETTA, GA
    ZIP 30062
  • Facility Phone: 678 381-2020
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MILAN R. PATEL
  • NPI Number: 1780075861
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2089612
LAB Type Ambulatory Surgery Center
Facility Name ROSWELL EYE SURGERY CENTER
Street 3775 ROSWELL ROAD SUITE 175
City MARIETTA
State GA
ZIP 30062
Phone 678 381-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Ambulatory Surgery Center
Lab Director MILAN R. PATEL

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