45D2084755 CLIA NUMBER - SAN ANTONIO CHILDRENS SURGICAL

Laboratory Demographics

  • CLIA Code: 45D2084755
  • Facility Name: SAN ANTONIO CHILDRENS SURGICAL
  • Facility Address: 8706 FREDERICKSBURG ROAD, SUITE 104
    SAN ANTONIO, TX
    ZIP 78240
  • Facility Phone: 210 714-2488
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KETAN SUKKAWALA
  • NPI Number: 1144650060
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2084755
LAB Type Ambulatory Surgery Center
Facility Name SAN ANTONIO CHILDRENS SURGICAL
Street 8706 FREDERICKSBURG ROAD, SUITE 104
City SAN ANTONIO
State TX
ZIP 78240
Phone 210 714-2488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Ambulatory Surgery Center
Lab Director KETAN SUKKAWALA

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