11D2171126 CLIA NUMBER - MARIETTA ADVANCED SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D2171126
  • Facility Name: MARIETTA ADVANCED SURGERY CENTER
  • Facility Address: 1371 CHURCH STREET EXT, NE, SUITE 100
    MARIETTA, GA
    ZIP 30060
  • Facility Phone: 678 344-8900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JITESH V. PATEL
  • NPI Number: 1285108845
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2171126
LAB Type Ambulatory Surgery Center
Facility Name MARIETTA ADVANCED SURGERY CENTER
Street 1371 CHURCH STREET EXT, NE, SUITE 100
City MARIETTA
State GA
ZIP 30060
Phone 678 344-8900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Ambulatory Surgery Center
Lab Director JITESH V. PATEL

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