26D1023601 CLIA NUMBER - CHESTERFIELD AMBULATORY SURGERY CENTER, LP

Laboratory Demographics

CLIA Number: 26D1023601

Facility Name: CHESTERFIELD AMBULATORY SURGERY CENTER, LP

Facility Address:
17050 BAXTER RD SUITE 110
CHESTERFIELD, MO
ZIP 63005
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Facility Phone Number: 636 537-0122

Facility Type: Ambulatory Surgery Center

Certificate Type: Certificate of Compliance

NPI Number: 1255373601

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D1023601
LAB Type	Ambulatory Surgery Center
Facility Name	CHESTERFIELD AMBULATORY SURGERY CENTER, LP
Street	17050 BAXTER RD SUITE 110
City	CHESTERFIELD
State	MO
ZIP	63005
Phone	636 537-0122
CertificateType	2
CertificateEffectiveDate	9/27/2022
CertificateExpirationDate	9/26/2024
FacilityType	Compliance

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