11D2097499 CLIA NUMBER - WEST PACES SURGERY CTR, LLC

Laboratory Demographics

  • CLIA Code: 11D2097499
  • Facility Name: WEST PACES SURGERY CTR, LLC
  • Facility Address: 3200 DOWNWOOD CIRCLE, SUITE 400
    ATLANTA, GA
    ZIP 30327
  • Facility Phone: 404 969-7614
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RAJIV D. PANDYA
  • NPI Number: 1992192488
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2097499
LAB Type Ambulatory Surgery Center
Facility Name WEST PACES SURGERY CTR, LLC
Street 3200 DOWNWOOD CIRCLE, SUITE 400
City ATLANTA
State GA
ZIP 30327
Phone 404 969-7614
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Ambulatory Surgery Center
Lab Director RAJIV D. PANDYA

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