11D1048945 CLIA NUMBER - NORTHEAST ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 11D1048945
  • Facility Name: NORTHEAST ENDOSCOPY CENTER
  • Facility Address: 721 WELLNESS WAY SUITE 110
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 678 879-0999
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: AMY BEASLEY
  • NPI Number: 1578531208
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1048945
LAB Type Ambulatory Surgery Center
Facility Name NORTHEAST ENDOSCOPY CENTER
Street 721 WELLNESS WAY SUITE 110
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 678 879-0999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type Ambulatory Surgery Center
Lab Director AMY BEASLEY

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