36D1100016 CLIA NUMBER - GASTRO CARE LLC

Laboratory Demographics

  • CLIA Code: 36D1100016
  • Facility Name: GASTRO CARE LLC
  • Facility Address: 2355 DERR ROAD
    SPRINGFIELD, OH
    ZIP 45503
  • Facility Phone: 937 629-3600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CHALLA AJIT
  • NPI Number: 1740424944
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D1100016
LAB Type Ambulatory Surgery Center
Facility Name GASTRO CARE LLC
Street 2355 DERR ROAD
City SPRINGFIELD
State OH
ZIP 45503
Phone 937 629-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2025
Certificate Expiration Date 5/27/2027
Facility Type Ambulatory Surgery Center
Lab Director CHALLA AJIT

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