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ADVANCED SURGICAL TECHNOLOGY, LLC
NPI 1497159024
Surgery in Mount Vernon, IL

Active since October 10, 2014CLIA Certified · 3 labs
4200 WILLIAMSON PL STE 1A, MOUNT VERNON, IL 62864(618) 899-9200(618) 899-9206 Get Directions Write a Review

NPPES record last updated: July 17, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Advanced Surgical Technology, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVANCED SURGICAL TECHNOLOGY, LLC (NPI 1497159024) is a healthcare organization registered as a surgery in Mount Vernon, Illinois and active in the NPI registry since October 2014. The organization holds 3 active CLIA laboratory certificates and lists Sandra L Adams, Office Administrator, as its authorized official.

NPPES Registry Identity

NPI1497159024
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameADVANCED SURGICAL TECHNOLOGY, LLC
Location Address4200 WILLIAMSON PL STE 1AMount Vernon, IL 62864-6705
Mailing Address4200 Williamson Pl Ste 1aMount Vernon, IL 62864-6705 · (618) 899-9200 · Fax (618) 899-9206
Phone(618) 899-9200
Fax(618) 899-9206
Organization SubpartNo
Authorized OfficialSandra L AdamsOffice Administrator · (618) 969-8317
Enumeration DateOctober 10, 2014
Last NPPES UpdateJuly 17, 2019
✔ NPI 1497159024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IL · 036115674
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
4200 WILLIAMSON PL STE 1A, Mount Vernon, IL 62864
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2172502

Advanced Surgical Technology, L L C · Mount Vernon, IL
Active · expires Mar 1, 2027
CLIA Number14D2172502
Laboratory TypePhysician Office
Certificate Effective DateMarch 2, 2025
Certificate Expiration DateMarch 1, 2027
Laboratory DirectorUdaya K. Liyanage M D
Laboratory Phone(618) 899-9200
Laboratory LocationAdvanced Surgical Technology, L L C4200 Williamson Pl - Ste 1A, Mount Vernon, IL 62864
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D2231713

Advanced Surgical Technology, LLC · Centralia, IL
Active · expires Jan 7, 2028
CLIA Number14D2231713
Laboratory TypePhysician Office
Certificate Effective DateJanuary 8, 2026
Certificate Expiration DateJanuary 7, 2028
Laboratory DirectorUdaya K. Liyanage
Laboratory Phone(618) 899-9200
Laboratory LocationAdvanced Surgical Technology, LLC1307 E Mccord, Centralia, IL 62801
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 14D2292466

Advanced Surgical Technology LLC · Mount Vernon, IL
Active · expires Nov 14, 2026
CLIA Number14D2292466
Laboratory TypePhysician Office
Certificate Effective DateNovember 15, 2024
Certificate Expiration DateNovember 14, 2026
Laboratory DirectorUdaya K. Liyanage
Laboratory Phone(618) 899-9533
Laboratory LocationAdvanced Surgical Technology LLC3120 Veterans Memorial Drive, Mount Vernon, IL 62864
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADVANCED SURGICAL TECHNOLOGY, LLC
Clinic/Center (Rural Health)
4200 WILLIAMSON PL STE 1A
MOUNT VERNON, IL 62864
Jefferson County (618) 899-9195
MACEY GETTINGER
Nurse Practitioner
4200 WILLIAMSON PL STE 1A
MOUNT VERNON, IL 62864
Jefferson County (618) 899-9200
DR. UDAYA K LIYANAGE MD
Surgery
4200 WILLIAMSON PL STE 1A
MOUNT VERNON, IL 62864
Jefferson County (618) 899-9200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Advanced Surgical Technology, LLC's NPI number?

The NPI number for Advanced Surgical Technology, LLC is 1497159024. It was assigned to this organization in the NPPES registry on October 10, 2014.

Where is Advanced Surgical Technology, LLC located?

Advanced Surgical Technology, LLC is located at 4200 Williamson Pl Ste 1A, Mount Vernon, IL 62864. The listed phone number is (618) 899-9200.

What is Advanced Surgical Technology, LLC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Does Advanced Surgical Technology, LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Advanced Surgical Technology, LLC was last updated on July 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.