45D2137481 CLIA NUMBER - LONE STAR ENDOSCOPY CENTER, LLC SOUTHLAKE

Laboratory Demographics

  • CLIA Code: 45D2137481
  • Facility Name: LONE STAR ENDOSCOPY CENTER, LLC SOUTHLAKE
  • Facility Address: 515 SOUTH NOLEN DRIVE
    SOUTHLAKE, TX
    ZIP 76092
  • Facility Phone: 817 912-1999
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JEFFREY A. SMITH
  • NPI Number: 1154844553
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2137481
LAB Type Ambulatory Surgery Center
Facility Name LONE STAR ENDOSCOPY CENTER, LLC SOUTHLAKE
Street 515 SOUTH NOLEN DRIVE
City SOUTHLAKE
State TX
ZIP 76092
Phone 817 912-1999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2025
Certificate Expiration Date 9/26/2027
Facility Type Ambulatory Surgery Center
Lab Director JEFFREY A. SMITH

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