49D1079127 CLIA NUMBER - COLONIAL GASTROENTEROLOGY ASSOCIATES DIVISION OF CAPITAL DIGESTIVE CARE

Laboratory Demographics

  • CLIA Code: 49D1079127
  • Facility Name: COLONIAL GASTROENTEROLOGY ASSOCIATES DIVISION OF CAPITAL DIGESTIVE CARE
  • Facility Address: 400 SENTARA CIRCLE - SUITE 103
    WILLIAMSBURG, VA
    ZIP 23188
  • Facility Phone: 757 534-7701
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: RAVI CHHATRALA
  • NPI Number: 1639316318
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 49D1079127
LAB Type Mobile Laboratory
Facility Name COLONIAL GASTROENTEROLOGY ASSOCIATES DIVISION OF CAPITAL DIGESTIVE CARE
Street 400 SENTARA CIRCLE - SUITE 103
City WILLIAMSBURG
State VA
ZIP 23188
Phone 757 534-7701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Mobile Laboratory
Lab Director RAVI CHHATRALA

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