44D0885934 CLIA NUMBER - ENDOSCOPY CENTER OF KINGSPORT DBA SULLIVAN DIGESTIVE CENTER

Laboratory Demographics

  • CLIA Code: 44D0885934
  • Facility Name: ENDOSCOPY CENTER OF KINGSPORT DBA SULLIVAN DIGESTIVE CENTER
  • Facility Address: 2204 PAVILION DRIVE STE 108
    KINGSPORT, TN
    ZIP 37660
  • Facility Phone: 423 392-6100
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. SULLIVAN MD
  • NPI Number: 1235140385
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D0885934
LAB Type Ambulatory Surgery Center
Facility Name ENDOSCOPY CENTER OF KINGSPORT DBA SULLIVAN DIGESTIVE CENTER
Street 2204 PAVILION DRIVE STE 108
City KINGSPORT
State TN
ZIP 37660
Phone 423 392-6100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2024
Certificate Expiration Date 5/9/2026
Facility Type Ambulatory Surgery Center
Lab Director MICHAEL J. SULLIVAN MD

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This page was last updated on: 6/4/2025