11D2238036 CLIA NUMBER - GASTRO SOUTH ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 11D2238036
  • Facility Name: GASTRO SOUTH ENDOSCOPY CENTER
  • Facility Address: 249 SHERATON BOULEVARD
    MACON, GA
    ZIP 31210
  • Facility Phone: 478 508-8113
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOEL JUDAH
  • NPI Number: 1538809009
  • Taxonomy: 367500000X - Nurse Anesthetist, Certified Registered

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CLIA Record

Field Name Field Value
CLIA Number 11D2238036
LAB Type Ambulatory Surgery Center
Facility Name GASTRO SOUTH ENDOSCOPY CENTER
Street 249 SHERATON BOULEVARD
City MACON
State GA
ZIP 31210
Phone 478 508-8113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Ambulatory Surgery Center
Lab Director JOEL JUDAH

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