33D1051896 CLIA NUMBER - UPSTATE GASTROENTEROLOGY LLC

Laboratory Demographics

  • CLIA Code: 33D1051896
  • Facility Name: UPSTATE GASTROENTEROLOGY LLC
  • Facility Address: 1000 E GENESEE ST - SUITE 206
    SYRACUSE, NY
    ZIP 13210
  • Facility Phone: 315 464-1616
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. SAVIO D. JOHN
  • NPI Number: 1366799033
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 33D1051896
LAB Type Ambulatory Surgery Center
Facility Name UPSTATE GASTROENTEROLOGY LLC
Street 1000 E GENESEE ST - SUITE 206
City SYRACUSE
State NY
ZIP 13210
Phone 315 464-1616
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2012
Certificate Expiration Date 3/26/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. SAVIO D. JOHN

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