11D1103719 CLIA NUMBER - GASTRO SPECIALISTS OF DEKALB

Laboratory Demographics

  • CLIA Code: 11D1103719
  • Facility Name: GASTRO SPECIALISTS OF DEKALB
  • Facility Address: 3292 MOUNTAIN DRIVE
    DECATUR, GA
    ZIP 30032
  • Facility Phone: 404 294-8180
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SHIRLEY A. HARRIS
  • NPI Number: 1023252954
  • Taxonomy: 261QE0800X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D1103719
LAB Type Ambulatory Surgery Center
Facility Name GASTRO SPECIALISTS OF DEKALB
Street 3292 MOUNTAIN DRIVE
City DECATUR
State GA
ZIP 30032
Phone 404 294-8180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2023
Certificate Expiration Date 8/16/2025
Facility Type Ambulatory Surgery Center
Lab Director SHIRLEY A. HARRIS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025