45D2147876 CLIA NUMBER - ST DAVID'S AUSTIN SURGERY CENTER

Laboratory Demographics

CLIA Number: 45D2147876

Facility Name: ST DAVID'S AUSTIN SURGERY CENTER

Facility Address:
12200 RENFERT WAY, SUITE G-2
AUSTIN, TX
ZIP 78758
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Facility Phone Number: 512 901-8340

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1568979805

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2147876
LAB Type	Ambulatory Surgery Center
Facility Name	ST DAVID'S AUSTIN SURGERY CENTER
Street	12200 RENFERT WAY, SUITE G-2
City	AUSTIN
State	TX
ZIP	78758
Phone	512 901-8340
CertificateType	4
CertificateEffectiveDate	4/30/2024
CertificateExpirationDate	4/29/2026
FacilityType	Waiver

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