11D2272070 CLIA NUMBER - LAFAYETTE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D2272070
  • Facility Name: LAFAYETTE SURGERY CENTER
  • Facility Address: 1015 LAFAYETTE PARKWAY SUITE 110
    LAGRANGE, GA
    ZIP 30241
  • Facility Phone: 678 754-3511
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: LESLIE MUI
  • NPI Number: 1164882635
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 11D2272070
LAB Type Ambulatory Surgery Center
Facility Name LAFAYETTE SURGERY CENTER
Street 1015 LAFAYETTE PARKWAY SUITE 110
City LAGRANGE
State GA
ZIP 30241
Phone 678 754-3511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Ambulatory Surgery Center
Lab Director LESLIE MUI

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