45D2118038 CLIA NUMBER - WATER LEAF SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 45D2118038
  • Facility Name: WATER LEAF SURGERY CENTER
  • Facility Address: 5200 B DAVIS LANE, SUITE 100 ATTN CLIA LAB DIRECTOR
    AUSTIN, TX
    ZIP 78749
  • Facility Phone: 512 834-4141
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JERAKA ROSSOW
  • NPI Number: 1437505948
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2118038
LAB Type Ambulatory Surgery Center
Facility Name WATER LEAF SURGERY CENTER
Street 5200 B DAVIS LANE, SUITE 100 ATTN CLIA LAB DIRECTOR
City AUSTIN
State TX
ZIP 78749
Phone 512 834-4141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Ambulatory Surgery Center
Lab Director JERAKA ROSSOW

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