11D2224667 CLIA NUMBER - GEORGIA INTERVENTINAL PAIN I, LLC

Laboratory Demographics

  • CLIA Code: 11D2224667
  • Facility Name: GEORGIA INTERVENTINAL PAIN I, LLC
  • Facility Address: 18 RIVERBEND DRIVE, SW, SUITE 120
    ROME, GA
    ZIP 30161
  • Facility Phone: 770 962-3642
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: AMIT PATEL
  • NPI Number: 1295532968
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2224667
LAB Type Ambulatory Surgery Center
Facility Name GEORGIA INTERVENTINAL PAIN I, LLC
Street 18 RIVERBEND DRIVE, SW, SUITE 120
City ROME
State GA
ZIP 30161
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 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Ambulatory Surgery Center
Lab Director AMIT PATEL

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