26D1013840 CLIA NUMBER - TIMBERLAKE SURGERY CENTER

Laboratory Demographics

CLIA Number: 26D1013840

Facility Name: TIMBERLAKE SURGERY CENTER

Facility Address:
14825 N OUTER FORTY RD, STE 100
CHESTERFIELD, MO
ZIP 63017
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Facility Phone Number: 636 898-4695

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1346292372

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D1013840
LAB Type	Ambulatory Surgery Center
Facility Name	TIMBERLAKE SURGERY CENTER
Street	14825 N OUTER FORTY RD, STE 100
City	CHESTERFIELD
State	MO
ZIP	63017
Phone	636 898-4695
CertificateType	4
CertificateEffectiveDate	6/18/2023
CertificateExpirationDate	6/17/2025
FacilityType	Waiver

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