11D1034943 CLIA NUMBER - GASTROENTEROLOGY SPECIALISTS OF DEKALB

Laboratory Demographics

CLIA Number: 11D1034943

Facility Name: GASTROENTEROLOGY SPECIALISTS OF DEKALB

Facility Address:
3292 MOUNTAIN DRIVE,SUITE A
DECATUR, GA
ZIP 30032
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Facility Phone Number: 404 294-8180

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144350869

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	11D1034943
LAB Type	Physician Office
Facility Name	GASTROENTEROLOGY SPECIALISTS OF DEKALB
Street	3292 MOUNTAIN DRIVE,SUITE A
City	DECATUR
State	GA
ZIP	30032
Phone	404 294-8180
CertificateType	4
CertificateEffectiveDate	12/16/2022
CertificateExpirationDate	12/15/2024
FacilityType	Waiver

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