44D0990607 CLIA NUMBER - ATHENS SURGERY CENTER, LLC DBA THE SURGERY CENTER OF ATHENS

Laboratory Demographics

CLIA Number: 44D0990607

Facility Name: ATHENS SURGERY CENTER, LLC DBA THE SURGERY CENTER OF ATHENS

Facility Address:
105 NORTH MEADOWS DRIVE
ATHENS, TN
ZIP 37303
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Facility Phone Number: 423 649-3300

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1316290380

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D0990607
LAB Type	Ambulatory Surgery Center
Facility Name	ATHENS SURGERY CENTER, LLC DBA THE SURGERY CENTER OF ATHENS
Street	105 NORTH MEADOWS DRIVE
City	ATHENS
State	TN
ZIP	37303
Phone	423 649-3300
CertificateType	4
CertificateEffectiveDate	8/28/2023
CertificateExpirationDate	8/27/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024