11D2257251 CLIA NUMBER - CENTER FOR SPINE INTERVENTION PC

Laboratory Demographics

  • CLIA Code: 11D2257251
  • Facility Name: CENTER FOR SPINE INTERVENTION PC
  • Facility Address: 72 PLAZA WAY
    MARIETTA, GA
    ZIP 30060
  • Facility Phone: 678 813-2741
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANANTHA KAMATH
  • NPI Number: 1366989741
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2257251
LAB Type Physician Office
Facility Name CENTER FOR SPINE INTERVENTION PC
Street 72 PLAZA WAY
City MARIETTA
State GA
ZIP 30060
Phone 678 813-2741
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Physician Office
Lab Director ANANTHA KAMATH

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