11D2279255 CLIA NUMBER - BRASELTON ASC, LLC

Laboratory Demographics

  • CLIA Code: 11D2279255
  • Facility Name: BRASELTON ASC, LLC
  • Facility Address: 1524 RIVER PLACE, SUITE 100
    BRASELTON, GA
    ZIP 30517
  • Facility Phone: 770 848-8600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DAVID R. BAILEY
  • NPI Number: 1194974907
  • Taxonomy: 261QM2500X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2279255
LAB Type Ambulatory Surgery Center
Facility Name BRASELTON ASC, LLC
Street 1524 RIVER PLACE, SUITE 100
City BRASELTON
State GA
ZIP 30517
Phone 770 848-8600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Ambulatory Surgery Center
Lab Director DAVID R. BAILEY

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: 9/29/2025