34D2247863 CLIA NUMBER - DIGESTIVE ASC LLC

Laboratory Demographics

CLIA Number: 34D2247863

Facility Name: DIGESTIVE ASC LLC

Facility Address:
649 GUY ROAD
CLAYTON, NC
ZIP 27520
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Facility Phone Number: 919 938-4404

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558951319

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2247863
LAB Type	Physician Office
Facility Name	DIGESTIVE ASC LLC
Street	649 GUY ROAD
City	CLAYTON
State	NC
ZIP	27520
Phone	919 938-4404
CertificateType	4
CertificateEffectiveDate	1/10/2024
CertificateExpirationDate	1/9/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024