11D2128974 CLIA NUMBER - RESURGENS FAYETTE SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 11D2128974
  • Facility Name: RESURGENS FAYETTE SURGERY CENTER, LLC
  • Facility Address: 1336 HIGHWAY 54 W, BUILDING 400, SUITE A
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 678 422-4280
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARK ALBRITTON
  • NPI Number: 1649307885
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D2128974
LAB Type Ambulatory Surgery Center
Facility Name RESURGENS FAYETTE SURGERY CENTER, LLC
Street 1336 HIGHWAY 54 W, BUILDING 400, SUITE A
City FAYETTEVILLE
State GA
ZIP 30214
Phone 678 422-4280
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Ambulatory Surgery Center
Lab Director MARK ALBRITTON

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