11D1000858 CLIA NUMBER - ATHENS GASTROENTEROLOGY

Laboratory Demographics

  • CLIA Code: 11D1000858
  • Facility Name: ATHENS GASTROENTEROLOGY
  • Facility Address: 21 JEFFERSON STREET
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 548-0058
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGORY SMITH MD
  • NPI Number: 1225237191
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D1000858
LAB Type Physician Office
Facility Name ATHENS GASTROENTEROLOGY
Street 21 JEFFERSON STREET
City ATHENS
State GA
ZIP 30606
Phone 706 548-0058
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2024
Certificate Expiration Date 6/24/2026
Facility Type Physician Office
Lab Director GREGORY SMITH MD

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