45D2177117 CLIA NUMBER - PRECISION AMBULATORY SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 45D2177117

Facility Name: PRECISION AMBULATORY SURGERY CENTER, LLC

Facility Address:
9439 N BEACH ST
FORT WORTH, TX
ZIP 76244
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Facility Phone Number: 682 499-3679

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1962050492

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2177117
LAB Type	Ambulatory Surgery Center
Facility Name	PRECISION AMBULATORY SURGERY CENTER, LLC
Street	9439 N BEACH ST
City	FORT WORTH
State	TX
ZIP	76244
Phone	682 499-3679
CertificateType	4
CertificateEffectiveDate	1/6/2024
CertificateExpirationDate	1/5/2026
FacilityType	Waiver

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