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

Laboratory Demographics

  • CLIA Code: 45D2147876
  • Facility Name: ST DAVID'S AUSTIN SURGERY CENTER
  • Facility Address: 12200 RENFERT WAY, SUITE G-2
    AUSTIN, TX
    ZIP 78758
  • Facility Phone: 512 901-8340
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ISIAH GORDON
  • NPI Number: 1568979805
  • Taxonomy: 261QA1903X - Clinic/Center

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Ambulatory Surgery Center
Lab Director ISIAH GORDON

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