10D2051281 CLIA NUMBER - ADVANCED GASTROENTEROLOGY

Laboratory Demographics

  • CLIA Code: 10D2051281
  • Facility Name: ADVANCED GASTROENTEROLOGY
  • Facility Address: 6152 W CORPORATE OAKS DR
    CRYSTAL RIVER, FL
    ZIP 34429
  • Facility Phone: 352 564-3900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: B JEFFREY WALLIS
  • NPI Number: 1003199076
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2051281
LAB Type Physician Office
Facility Name ADVANCED GASTROENTEROLOGY
Street 6152 W CORPORATE OAKS DR
City CRYSTAL RIVER
State FL
ZIP 34429
Phone 352 564-3900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Physician Office
Lab Director B JEFFREY WALLIS

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