11D0990765 CLIA NUMBER - GI DIAGNOSTICS ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 11D0990765
  • Facility Name: GI DIAGNOSTICS ENDOSCOPY CENTER
  • Facility Address: 2550 WINDY HILL ROAD SUITE 302
    MARIETTA, GA
    ZIP 30067
  • Facility Phone: 770 226-9070
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SHANNON L. MOULTON
  • NPI Number: 1205803699
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0990765
LAB Type Ambulatory Surgery Center
Facility Name GI DIAGNOSTICS ENDOSCOPY CENTER
Street 2550 WINDY HILL ROAD SUITE 302
City MARIETTA
State GA
ZIP 30067
Phone 770 226-9070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Ambulatory Surgery Center
Lab Director SHANNON L. MOULTON

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