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PLASTIC SURGERY OPERATIVE SUITE, LLC
NPI 1316121429
Clinic/Center - Ambulatory Surgical in Valdosta, GA

Active since December 26, 2007CLIA 11D1012817 · Waiver
230 NORTHSIDE DR, VALDOSTA, GA 31602(229) 242-3002 Get Directions Write a Review

NPPES record last updated: May 5, 2015. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Plastic Surgery Operative Suite, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PLASTIC SURGERY OPERATIVE SUITE, LLC (NPI 1316121429) is a healthcare organization registered as an ambulatory surgical in Valdosta, Georgia and active in the NPI registry since December 2007. The organization holds a CLIA Waiver certificate valid through May 21, 2027 and lists Mandy Parks, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1316121429
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NamePLASTIC SURGERY OPERATIVE SUITE, LLC
Location Address230 NORTHSIDE DRValdosta, GA 31602-1858
Mailing Address230 Northside DrValdosta, GA 31602-1858
Phone(229) 242-3002
Organization SubpartNo
Authorized OfficialMandy ParksPractice Administrator · (229) 242-3002
Enumeration DateDecember 26, 2007
Last NPPES UpdateMay 5, 2015
✔ NPI 1316121429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
230 NORTHSIDE DR, Valdosta, GA 31602
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Other Identifiers 1

Medicare PIN111229ASCAGA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D1012817

Plastic Surgery Operative Suite LLC · Valdosta, GA
Active · expires May 21, 2027
CLIA Number11D1012817
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateMay 22, 2025
Certificate Expiration DateMay 21, 2027
Laboratory DirectorSonja J. Merriman
Laboratory Phone(229) 242-3002
Laboratory LocationPlastic Surgery Operative Suite LLC230 Northside Drive, Valdosta, GA 31602
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PLASTIC SURGERY ASSOCIATES OF VALDOSTA
Clinic/Center (Medical Specialty)
230 NORTHSIDE DR
VALDOSTA, GA 31602
Lowndes County (229) 242-3002
MARK ARTHUR PLEASANTS CRNA
Nurse Anesthetist, Certified Registered
230 NORTHSIDE DR
VALDOSTA, GA 31602
Lowndes County (229) 242-3002
SONYA J. MERRIMAN M.D.
Plastic Surgery
230 NORTHSIDE DR
VALDOSTA, GA 31602
Lowndes County (229) 242-3002

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Plastic Surgery Operative Suite, LLC's NPI number?

The NPI number for Plastic Surgery Operative Suite, LLC is 1316121429. It was assigned to this organization in the NPPES registry on December 26, 2007.

Where is Plastic Surgery Operative Suite, LLC located?

Plastic Surgery Operative Suite, LLC is located at 230 Northside Dr, Valdosta, GA 31602. The listed phone number is (229) 242-3002.

What is Plastic Surgery Operative Suite, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Plastic Surgery Operative Suite, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1012817) is associated with this NPI, valid through May 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Plastic Surgery Operative Suite, LLC was last updated on May 5, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.