45D2073441 CLIA NUMBER - PARK AMBULATORY SURGERY CENTER

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Laboratory Demographics

CLIA Number: 45D2073441

Facility Name: PARK AMBULATORY SURGERY CENTER

Facility Address:
5055 PARK BLVD #800A
PLANO, TX
ZIP 75093
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Facility Phone Number: 214 299-7010

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1922438472

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2073441
LAB Type	Ambulatory Surgery Center
Facility Name	PARK AMBULATORY SURGERY CENTER
Street	5055 PARK BLVD #800A
City	PLANO
State	TX
ZIP	75093
Phone	214 299-7010
CertificateType	4
CertificateEffectiveDate	2/19/2024
CertificateExpirationDate	2/18/2026
FacilityType	Waiver

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