45D2137229 CLIA NUMBER - COPPELL SURGERY CENTER OF HORIZON MEDICAL CENTER

Laboratory Demographics

CLIA Number: 45D2137229

Facility Name: COPPELL SURGERY CENTER OF HORIZON MEDICAL CENTER

Facility Address:
731 PLAZA ROAD
COPPELL, TX
ZIP 75019
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Facility Phone Number: 469 451-5700

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1619429289

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2137229
LAB Type	Ambulatory Surgery Center
Facility Name	COPPELL SURGERY CENTER OF HORIZON MEDICAL CENTER
Street	731 PLAZA ROAD
City	COPPELL
State	TX
ZIP	75019
Phone	469 451-5700
CertificateType	4
CertificateEffectiveDate	9/22/2023
CertificateExpirationDate	9/21/2025
FacilityType	Waiver

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