11D2282943 CLIA NUMBER - POOLER PLASTIC SURGERY LLC

Laboratory Demographics

  • CLIA Code: 11D2282943
  • Facility Name: POOLER PLASTIC SURGERY LLC
  • Facility Address: 1000 TOWNE CENTER BOULEVARD, CUITE 506
    POOLER, GA
    ZIP 31322
  • Facility Phone: 912 988-1781
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: FRANCIS C. PETTIGREW
  • NPI Number: 1194284299
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D2282943
LAB Type Ambulatory Surgery Center
Facility Name POOLER PLASTIC SURGERY LLC
Street 1000 TOWNE CENTER BOULEVARD, CUITE 506
City POOLER
State GA
ZIP 31322
Phone 912 988-1781
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Ambulatory Surgery Center
Lab Director FRANCIS C. PETTIGREW

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