11D2325133 CLIA NUMBER - SOUTHEASTERN AESTHETIC SURGERY

Laboratory Demographics

  • CLIA Code: 11D2325133
  • Facility Name: SOUTHEASTERN AESTHETIC SURGERY
  • Facility Address: 225 COOPER COURT
    AUGUSTA, GA
    ZIP 30907
  • Facility Phone: 706 854-2080
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM T. AUSTIN
  • NPI Number: 1962793505
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D2325133
LAB Type Physician Office
Facility Name SOUTHEASTERN AESTHETIC SURGERY
Street 225 COOPER COURT
City AUGUSTA
State GA
ZIP 30907
Phone 706 854-2080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Physician Office
Lab Director WILLIAM T. AUSTIN

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