11D2174855 CLIA NUMBER - INTERNATIONAL SPINE AND PAIN MANAGEMENT CENTER, PC

Laboratory Demographics

  • CLIA Code: 11D2174855
  • Facility Name: INTERNATIONAL SPINE AND PAIN MANAGEMENT CENTER, PC
  • Facility Address: 6920 MCGINNIS FERRY ROAD, SUITE 360-B
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 404 920-4950
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATEL PREETESH
  • NPI Number: 1780209130
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 11D2174855
LAB Type Physician Office
Facility Name INTERNATIONAL SPINE AND PAIN MANAGEMENT CENTER, PC
Street 6920 MCGINNIS FERRY ROAD, SUITE 360-B
City SUWANEE
State GA
ZIP 30024
Phone 404 920-4950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type Physician Office
Lab Director PATEL PREETESH

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