11D0973026 CLIA NUMBER - SUMMIT ENDOSCOPY CENTER LLC

Laboratory Demographics

  • CLIA Code: 11D0973026
  • Facility Name: SUMMIT ENDOSCOPY CENTER LLC
  • Facility Address: 1265 HWY 54 WEST STE 401-B
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 678 817-6505
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KIRAN KANJI
  • NPI Number: 1427052026
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0973026
LAB Type Ambulatory Surgery Center
Facility Name SUMMIT ENDOSCOPY CENTER LLC
Street 1265 HWY 54 WEST STE 401-B
City FAYETTEVILLE
State GA
ZIP 30214
Phone 678 817-6505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Ambulatory Surgery Center
Lab Director KIRAN KANJI

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