11D2177683 CLIA NUMBER - GEORGIA INTERVENTIONAL PAIN F, LLC

Laboratory Demographics

  • CLIA Code: 11D2177683
  • Facility Name: GEORGIA INTERVENTIONAL PAIN F, LLC
  • Facility Address: 1357 HEMBREE ROAD SUITE 230
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: 770 962-3642
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: AMIT PATEL
  • NPI Number: 1245654615
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2177683
LAB Type Ambulatory Surgery Center
Facility Name GEORGIA INTERVENTIONAL PAIN F, LLC
Street 1357 HEMBREE ROAD SUITE 230
City ROSWELL
State GA
ZIP 30076
Phone 770 962-3642
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Ambulatory Surgery Center
Lab Director AMIT PATEL

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