45D0882630 CLIA NUMBER - SOUTH PLAINS ENDOSCOPY CENTER

Laboratory Demographics

CLIA Number: 45D0882630

Facility Name: SOUTH PLAINS ENDOSCOPY CENTER

Facility Address:
3610 24TH STREET
LUBBOCK, TX
ZIP 79410
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Facility Phone Number: 806 797-1015

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1568419323

Taxonomy: 261QE0800X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D0882630
LAB Type	Ambulatory Surgery Center
Facility Name	SOUTH PLAINS ENDOSCOPY CENTER
Street	3610 24TH STREET
City	LUBBOCK
State	TX
ZIP	79410
Phone	806 797-1015
CertificateType	4
CertificateEffectiveDate	2/15/2024
CertificateExpirationDate	2/14/2026
FacilityType	Waiver

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