11D2197336 CLIA NUMBER - ALLIANCE SURGERY CENTER AT PEACHTREE CITY

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Laboratory Demographics

CLIA Number: 11D2197336

Facility Name: ALLIANCE SURGERY CENTER AT PEACHTREE CITY

Facility Address:
1975 HIGHWAY 54 W, SUITE 105
PEACHTREE CITY, GA
ZIP 30269
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Facility Phone Number: 404 920-4950

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1598372963

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2197336
LAB Type	Ambulatory Surgery Center
Facility Name	ALLIANCE SURGERY CENTER AT PEACHTREE CITY
Street	1975 HIGHWAY 54 W, SUITE 105
City	PEACHTREE CITY
State	GA
ZIP	30269
Phone	404 920-4950
CertificateType	4
CertificateEffectiveDate	10/23/2022
CertificateExpirationDate	10/22/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024