26D1017302 CLIA NUMBER - ADVANCED SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 26D1017302
  • Facility Name: ADVANCED SURGERY CENTER LLC
  • Facility Address: 12607 OLIVE BLVD
    SAINT LOUIS, MO
    ZIP 63141
  • Facility Phone: 314 205-1610
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PAUL A. TESSER
  • NPI Number: 1619965324
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D1017302
LAB Type Ambulatory Surgery Center
Facility Name ADVANCED SURGERY CENTER LLC
Street 12607 OLIVE BLVD
City SAINT LOUIS
State MO
ZIP 63141
Phone 314 205-1610
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2025
Certificate Expiration Date 9/21/2027
Facility Type Ambulatory Surgery Center
Lab Director PAUL A. TESSER

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This page was last updated on: 9/29/2025