11D2110521 CLIA NUMBER - APEX MEDICAL SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 11D2110521

Facility Name: APEX MEDICAL SURGERY CENTER, LLC

Facility Address:
1075 LAFAYETTE PARKWAY, SUITE 110
LAGRANGE, GA
ZIP 30241
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Facility Phone Number: 762 323-1030

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1508210378

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2110521
LAB Type	Ambulatory Surgery Center
Facility Name	APEX MEDICAL SURGERY CENTER, LLC
Street	1075 LAFAYETTE PARKWAY, SUITE 110
City	LAGRANGE
State	GA
ZIP	30241
Phone	762 323-1030
CertificateType	4
CertificateEffectiveDate	3/16/2024
CertificateExpirationDate	3/15/2026
FacilityType	Waiver

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