11D2322581 CLIA NUMBER - IPC DALTON ASC, LLC

Laboratory Demographics

  • CLIA Code: 11D2322581
  • Facility Name: IPC DALTON ASC, LLC
  • Facility Address: 1502 DUG GAP
    DALTON, GA
    ZIP 30720
  • Facility Phone: 706 847-0826
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOSHUA L. HARE
  • NPI Number: 1619777653
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2322581
LAB Type Ambulatory Surgery Center
Facility Name IPC DALTON ASC, LLC
Street 1502 DUG GAP
City DALTON
State GA
ZIP 30720
Phone 706 847-0826
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Ambulatory Surgery Center
Lab Director JOSHUA L. HARE

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