11D0942816 CLIA NUMBER - GASTROENTEROLOGY ENDOSCOPY CENTER INC

Laboratory Demographics

CLIA Number: 11D0942816

Facility Name: GASTROENTEROLOGY ENDOSCOPY CENTER INC

Facility Address:
550 PEACHTREE STREET NORTH EAST, SUITE 1750
ATLANTA, GA
ZIP 30308
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Facility Phone Number: 404 875-8669

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1306964853

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D0942816
LAB Type	Ambulatory Surgery Center
Facility Name	GASTROENTEROLOGY ENDOSCOPY CENTER INC
Street	550 PEACHTREE STREET NORTH EAST, SUITE 1750
City	ATLANTA
State	GA
ZIP	30308
Phone	404 875-8669
CertificateType	4
CertificateEffectiveDate	3/18/2024
CertificateExpirationDate	3/17/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024