14D2292466 CLIA NUMBER - ADVANCED SURGICAL TECHNOLOGY LLC

Laboratory Demographics

  • CLIA Code: 14D2292466
  • Facility Name: ADVANCED SURGICAL TECHNOLOGY LLC
  • Facility Address: 3120 VETERANS MEMORIAL DRIVE
    MOUNT VERNON, IL
    ZIP 62864
  • Facility Phone: 618 899-9533
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: UDAYA K. LIYANAGE
  • NPI Number: 1649957648
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2292466
LAB Type Physician Office
Facility Name ADVANCED SURGICAL TECHNOLOGY LLC
Street 3120 VETERANS MEMORIAL DRIVE
City MOUNT VERNON
State IL
ZIP 62864
Phone 618 899-9533
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Physician Office
Lab Director UDAYA K. LIYANAGE

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