11D2108805 CLIA NUMBER - AVVSC LAWRENCEVILLE

Laboratory Demographics

CLIA Number: 11D2108805

Facility Name: AVVSC LAWRENCEVILLE

Facility Address:
600 PROFESSIONAL DRIVE SUITE 160 B
LAWRENCEVILLE, GA
ZIP 30046
Get Directions

Facility Phone Number: 678 878-4555

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1427435007

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2108805
LAB Type	Ambulatory Surgery Center
Facility Name	AVVSC LAWRENCEVILLE
Street	600 PROFESSIONAL DRIVE SUITE 160 B
City	LAWRENCEVILLE
State	GA
ZIP	30046
Phone	678 878-4555
CertificateType	4
CertificateEffectiveDate	2/12/2024
CertificateExpirationDate	2/11/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024