11D2236490 CLIA NUMBER - HOUSTON ASC, LLC

Laboratory Demographics

CLIA Number: 11D2236490

Facility Name: HOUSTON ASC, LLC

Facility Address:
1659 WATSON BOULEVARD
WARNER ROBINS, GA
ZIP 31093
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Facility Phone Number: 478 329-3100

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1376115279

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2236490
LAB Type	Ambulatory Surgery Center
Facility Name	HOUSTON ASC, LLC
Street	1659 WATSON BOULEVARD
City	WARNER ROBINS
State	GA
ZIP	31093
Phone	478 329-3100
CertificateType	4
CertificateEffectiveDate	9/17/2023
CertificateExpirationDate	9/16/2025
FacilityType	Waiver

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