11D2128624 CLIA NUMBER - EASTSIDE ENDOSCOPY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 11D2128624
  • Facility Name: EASTSIDE ENDOSCOPY CENTER, LLC
  • Facility Address: 1805 HONEY CREEK COMMONS
    CONYERS, GA
    ZIP 30013
  • Facility Phone: 770 922-7000
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KARIM SHAKOOR
  • NPI Number: 1164953493
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2128624
LAB Type Ambulatory Surgery Center
Facility Name EASTSIDE ENDOSCOPY CENTER, LLC
Street 1805 HONEY CREEK COMMONS
City CONYERS
State GA
ZIP 30013
Phone 770 922-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Ambulatory Surgery Center
Lab Director KARIM SHAKOOR

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This page was last updated on: 6/4/2025