11D2162119 CLIA NUMBER - ALLSPINE SURGERY CENTER - 2

Laboratory Demographics

  • CLIA Code: 11D2162119
  • Facility Name: ALLSPINE SURGERY CENTER - 2
  • Facility Address: 1944 CLAIRMONT ROAD
    DECATUR, GA
    ZIP 30033
  • Facility Phone: 770 997-0600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SHAHRAM REZAIAMIRI
  • NPI Number: 1114480704
  • Taxonomy: 367500000X - Nurse Anesthetist, Certified Registered

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CLIA Record

Field Name Field Value
CLIA Number 11D2162119
LAB Type Ambulatory Surgery Center
Facility Name ALLSPINE SURGERY CENTER - 2
Street 1944 CLAIRMONT ROAD
City DECATUR
State GA
ZIP 30033
Phone 770 997-0600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2025
Certificate Expiration Date 2/17/2027
Facility Type Ambulatory Surgery Center
Lab Director SHAHRAM REZAIAMIRI

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