45D1017263 CLIA NUMBER - FIRST STREET SURGERY CENTER

Laboratory Demographics

CLIA Number: 45D1017263

Facility Name: FIRST STREET SURGERY CENTER

Facility Address:
411 FIRST STREET
BELLAIRE, TX
ZIP 77401
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Facility Phone Number: 832 723-0063

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1336267442

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D1017263
LAB Type	Ambulatory Surgery Center
Facility Name	FIRST STREET SURGERY CENTER
Street	411 FIRST STREET
City	BELLAIRE
State	TX
ZIP	77401
Phone	832 723-0063
CertificateType	4
CertificateEffectiveDate	9/22/2023
CertificateExpirationDate	9/21/2025
FacilityType	Waiver

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