CLIA lab
CLIA 11D2062719: Interventional Spine and Pain Mgmt Cntrs , PC, the
Canton, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2062719 belongs to Interventional Spine and Pain Mgmt Cntrs , PC, the in Canton, GA.
Certificate of Waiver, effective July 22, 2025, expires July 21, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- July 22, 2025
- Certificate expiration
- July 21, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 22, 2013
- Facility type
- Other practitioner
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D2062719
- Lab name
- Interventional Spine and Pain Mgmt Cntrs , PC, the
- Address
- 134 Riverstone Terrace, Suite 101, Canton, GA 30114
- Phone
- (404) 920-4972
- Fax
- (678) 399-5496
Annual test volume the lab reported
- Waived tests
- 2,400
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Ahs Surgery Center Canton, LLCCertificate of Waiver, Ambulatory surgery center11D2076515
- American Health Imaging of CantonCertificate of Waiver, Independent11D2075795
- Aqua Dermatology of Georgia, PCCertificate of Registration, Physician office11D2312115
- Atlanta Cancer Care Canton OfficeCertificate of Accreditation, Physician office11D2129965
- Atlanta North Dermatology & Skin CareCertificate of Registration, Physician office11D2324304
- Aylo Health - CantonCertificate of Accreditation, Physician office11D2290810
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Related
Questions
What is the CLIA number for Interventional Spine and Pain Mgmt Cntrs , PC, the in Canton?
11D2062719, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Interventional Spine and Pain Mgmt Cntrs , PC, the hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2062719 expire?
The CMS file lists July 21, 2027 as the certificate expiration date; the certificate took effect July 22, 2025.