26D2137138 CLIA NUMBER - SPECIALTY SURGERY OF ST LOUIS, LLC

Laboratory Demographics

  • CLIA Code: 26D2137138
  • Facility Name: SPECIALTY SURGERY OF ST LOUIS, LLC
  • Facility Address: 12855 NORTH FORTY DRIVE SUITE 100 NORTH TOWER
    SAINT LOUIS, MO
    ZIP 63141
  • Facility Phone: 314 594-8230
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ETAI GOLDENBERG
  • NPI Number: 1093230450
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2137138
LAB Type Ambulatory Surgery Center
Facility Name SPECIALTY SURGERY OF ST LOUIS, LLC
Street 12855 NORTH FORTY DRIVE SUITE 100 NORTH TOWER
City SAINT LOUIS
State MO
ZIP 63141
Phone 314 594-8230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2025
Certificate Expiration Date 9/20/2027
Facility Type Ambulatory Surgery Center
Lab Director ETAI GOLDENBERG

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