11D2100880 CLIA NUMBER - GEORGIA UROLOGY AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D2100880
  • Facility Name: GEORGIA UROLOGY AMBULATORY SURGERY CENTER
  • Facility Address: 11835 ALPHARETTA HIGHWAY, SUITE 100
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: 678 284-4686
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LEWIS KRITEMAN
  • NPI Number: 1316162506
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D2100880
LAB Type Physician Office
Facility Name GEORGIA UROLOGY AMBULATORY SURGERY CENTER
Street 11835 ALPHARETTA HIGHWAY, SUITE 100
City ROSWELL
State GA
ZIP 30076
Phone 678 284-4686
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Physician Office
Lab Director LEWIS KRITEMAN

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