45D1104095 CLIA NUMBER - SURGISTAR, LP

Laboratory Demographics

  • CLIA Code: 45D1104095
  • Facility Name: SURGISTAR, LP
  • Facility Address: 8315 WALNUT HILL LANE, SUITE 105
    DALLAS, TX
    ZIP 75231
  • Facility Phone: 214 363-9946
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOHN WALLACE
  • NPI Number: 1386877439
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1104095
LAB Type Ambulatory Surgery Center
Facility Name SURGISTAR, LP
Street 8315 WALNUT HILL LANE, SUITE 105
City DALLAS
State TX
ZIP 75231
Phone 214 363-9946
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Ambulatory Surgery Center
Lab Director JOHN WALLACE

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