11D2248493 CLIA NUMBER - SOUTHERN PAIN AND SPINE - ATHENS

Laboratory Demographics

  • CLIA Code: 11D2248493
  • Facility Name: SOUTHERN PAIN AND SPINE - ATHENS
  • Facility Address: 1500 OGLETHORPE AVENUE, BLDG 500 B
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 678 971-4167
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANKUR PATEL
  • NPI Number: 1336744770
  • Taxonomy: 208VP0014X - Pain Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2248493
LAB Type Physician Office
Facility Name SOUTHERN PAIN AND SPINE - ATHENS
Street 1500 OGLETHORPE AVENUE, BLDG 500 B
City ATHENS
State GA
ZIP 30606
Phone 678 971-4167
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2024
Certificate Expiration Date 1/12/2026
Facility Type Physician Office
Lab Director ANKUR PATEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025