11D2280035 CLIA NUMBER - ATHENS SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 11D2280035
  • Facility Name: ATHENS SURGERY CENTER, LLC
  • Facility Address: 1500 OGLETHORPE AVENUE, STE 500 A
    ATHENS, GA
    ZIP 30606
  • Facility Phone: (678) 971-4167
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JORDAN TATE
  • NPI Number: 1467140327
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2280035
LAB Type Ambulatory Surgery Center
Facility Name ATHENS SURGERY CENTER, LLC
Street 1500 OGLETHORPE AVENUE, STE 500 A
City ATHENS
State GA
ZIP 30606
Phone 6789714167
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Ambulatory Surgery Center
Lab Director JORDAN TATE

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This page was last updated on: 5/18/2026