11D0720150 CLIA NUMBER - DEKALB GASTROENTEROLOGY ASSOCIATES III, LLC

Laboratory Demographics

  • CLIA Code: 11D0720150
  • Facility Name: DEKALB GASTROENTEROLOGY ASSOCIATES III, LLC
  • Facility Address: 2675 N DECATUR RD SUITE 506
    DECATUR, GA
    ZIP 30033
  • Facility Phone: 404 299-1679
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARK A. STERN
  • NPI Number: 1508985425
  • Taxonomy: 207RG0100X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0720150
LAB Type Ambulatory Surgery Center
Facility Name DEKALB GASTROENTEROLOGY ASSOCIATES III, LLC
Street 2675 N DECATUR RD SUITE 506
City DECATUR
State GA
ZIP 30033
Phone 404 299-1679
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Ambulatory Surgery Center
Lab Director MARK A. STERN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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