45D2100118 CLIA NUMBER - PARKSIDE SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 45D2100118
  • Facility Name: PARKSIDE SURGERY CENTER LLC
  • Facility Address: 690 S LOOP 336 W SUITE 130
    CONROE, TX
    ZIP 77304
  • Facility Phone: 936 228-9799
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: NELSON A. TAJONG
  • NPI Number: 1790174274
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2100118
LAB Type Ambulatory Surgery Center
Facility Name PARKSIDE SURGERY CENTER LLC
Street 690 S LOOP 336 W SUITE 130
City CONROE
State TX
ZIP 77304
Phone 936 228-9799
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2025
Certificate Expiration Date 8/6/2027
Facility Type Ambulatory Surgery Center
Lab Director NELSON A. TAJONG

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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