45D0673876 CLIA NUMBER - HERITAGE SURGERY CENTER, LC DBA HERITAGE SURGERY CENTER

Laboratory Demographics

CLIA Number: 45D0673876

Facility Name: HERITAGE SURGERY CENTER, LC DBA HERITAGE SURGERY CENTER

Facility Address:
1501 REDBUD BLVD
MCKINNEY, TX
ZIP 75069
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Facility Phone Number: 972 430-4764

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1750457099

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D0673876
LAB Type	Ambulatory Surgery Center
Facility Name	HERITAGE SURGERY CENTER, LC DBA HERITAGE SURGERY CENTER
Street	1501 REDBUD BLVD
City	MCKINNEY
State	TX
ZIP	75069
Phone	972 430-4764
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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