11D2122985 CLIA NUMBER - AU SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 11D2122985

Facility Name: AU SURGERY CENTER, LLC

Facility Address:
1430 JOHN WESLEY GILBERT DRIVE
AUGUSTA, GA
ZIP 30912
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Facility Phone Number: 706 721-2411

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1841733326

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2122985
LAB Type	Ambulatory Surgery Center
Facility Name	AU SURGERY CENTER, LLC
Street	1430 JOHN WESLEY GILBERT DRIVE
City	AUGUSTA
State	GA
ZIP	30912
Phone	706 721-2411
CertificateType	4
CertificateEffectiveDate	12/12/2022
CertificateExpirationDate	12/11/2024
FacilityType	Waiver

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