44D0311055 CLIA NUMBER - GASTROENTEROLOGY ASSOCIATES

Laboratory Demographics

CLIA Number: 44D0311055

Facility Name: GASTROENTEROLOGY ASSOCIATES

Facility Address:
135 W RAVINE RD SUITE 3A
KINGSPORT, TN
ZIP 37660
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Facility Phone Number: 423 246-6777

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1235330994

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	44D0311055
LAB Type	Physician Office
Facility Name	GASTROENTEROLOGY ASSOCIATES
Street	135 W RAVINE RD SUITE 3A
City	KINGSPORT
State	TN
ZIP	37660
Phone	423 246-6777
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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