04D1071449 CLIA NUMBER - GASTRO-INTESTINAL CENTER INC,THE

Laboratory Demographics

  • CLIA Code: 04D1071449
  • Facility Name: GASTRO-INTESTINAL CENTER INC,THE
  • Facility Address: 10001 LILE DRIVE
    LITTLE ROCK, AR
    ZIP 72205
  • Facility Phone: 501 663-1074
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BRUCE M. JOHNSON
  • NPI Number: 1215919329
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D1071449
LAB Type Ambulatory Surgery Center
Facility Name GASTRO-INTESTINAL CENTER INC,THE
Street 10001 LILE DRIVE
City LITTLE ROCK
State AR
ZIP 72205
Phone 501 663-1074
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2025
Certificate Expiration Date 7/25/2027
Facility Type Ambulatory Surgery Center
Lab Director BRUCE M. JOHNSON

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