11D2118407 CLIA NUMBER - MIDTOWN SURGERY CENTER

Laboratory Demographics

CLIA Number: 11D2118407

Facility Name: MIDTOWN SURGERY CENTER

Facility Address:
1224 STARK AVENUE
COLUMBUS, GA
ZIP 31906
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Facility Phone Number: 706 243-7010

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1295287522

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2118407
LAB Type	Ambulatory Surgery Center
Facility Name	MIDTOWN SURGERY CENTER
Street	1224 STARK AVENUE
City	COLUMBUS
State	GA
ZIP	31906
Phone	706 243-7010
CertificateType	4
CertificateEffectiveDate	9/7/2022
CertificateExpirationDate	9/6/2024
FacilityType	Waiver

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