11D2196147 CLIA NUMBER - LEGACY CENTER FOR SPINAL SURGERY, LLC

Laboratory Demographics

  • CLIA Code: 11D2196147
  • Facility Name: LEGACY CENTER FOR SPINAL SURGERY, LLC
  • Facility Address: 1900 EXCHANGE, SE, SUITE 610
    ATLANTA, GA
    ZIP 30339
  • Facility Phone: 770 771-3900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SAID ELSHIHABI
  • NPI Number: 1144845116
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2196147
LAB Type Ambulatory Surgery Center
Facility Name LEGACY CENTER FOR SPINAL SURGERY, LLC
Street 1900 EXCHANGE, SE, SUITE 610
City ATLANTA
State GA
ZIP 30339
Phone 770 771-3900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2024
Certificate Expiration Date 10/14/2026
Facility Type Ambulatory Surgery Center
Lab Director SAID ELSHIHABI

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