11D2302954 CLIA NUMBER - VASCULAR SURGICAL ASSOCIATES, PC

Laboratory Demographics

  • CLIA Code: 11D2302954
  • Facility Name: VASCULAR SURGICAL ASSOCIATES, PC
  • Facility Address: 6095 PROFESSIONAL PARKWAY, SUITE B203
    DOUGLASVILLE, GA
    ZIP 30134
  • Facility Phone: 770 423-0595
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL R. COREY
  • NPI Number: 1114083532
  • Taxonomy: 2086S0129X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D2302954
LAB Type Physician Office
Facility Name VASCULAR SURGICAL ASSOCIATES, PC
Street 6095 PROFESSIONAL PARKWAY, SUITE B203
City DOUGLASVILLE
State GA
ZIP 30134
Phone 770 423-0595
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Physician Office
Lab Director MICHAEL R. COREY

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