11D2327731 CLIA NUMBER - CHASTAIN SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D2327731
  • Facility Name: CHASTAIN SURGERY CENTER
  • Facility Address: 183 MYSTIC PLACE NE
    ATLANTA, GA
    ZIP 30342
  • Facility Phone: 470 851-1413
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. ALAN LARSEN
  • NPI Number: 1245041979
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2327731
LAB Type Ambulatory Surgery Center
Facility Name CHASTAIN SURGERY CENTER
Street 183 MYSTIC PLACE NE
City ATLANTA
State GA
ZIP 30342
Phone 470 851-1413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. ALAN LARSEN

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