11D2107612 CLIA NUMBER - SOUTHERN SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D2107612
  • Facility Name: SOUTHERN SURGERY CENTER
  • Facility Address: 605 NORTH WESTOVER BLVD
    ALBANY, GA
    ZIP 31707
  • Facility Phone: 229 434-4200
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOHN B. DAVIS JR
  • NPI Number: 1184083958
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2107612
LAB Type Ambulatory Surgery Center
Facility Name SOUTHERN SURGERY CENTER
Street 605 NORTH WESTOVER BLVD
City ALBANY
State GA
ZIP 31707
Phone 229 434-4200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Ambulatory Surgery Center
Lab Director JOHN B. DAVIS JR

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