45D2155351 CLIA NUMBER - SURGERY CENTER 121 LLC

Laboratory Demographics

  • CLIA Code: 45D2155351
  • Facility Name: SURGERY CENTER 121 LLC
  • Facility Address: 9955 GILLESPIE DRIVE SUITE 200
    PLANO, TX
    ZIP 75025
  • Facility Phone: 469 606-0060
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DAIN B. BROOKS
  • NPI Number: 1093295545
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2155351
LAB Type Ambulatory Surgery Center
Facility Name SURGERY CENTER 121 LLC
Street 9955 GILLESPIE DRIVE SUITE 200
City PLANO
State TX
ZIP 75025
Phone 469 606-0060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Ambulatory Surgery Center
Lab Director DAIN B. BROOKS

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