45D2181111 CLIA NUMBER - GULFSTREAM PARC ASC, LLC

Laboratory Demographics

  • CLIA Code: 45D2181111
  • Facility Name: GULFSTREAM PARC ASC, LLC
  • Facility Address: 3716 STANDRIDGE DR SUITE 100
    THE COLONY, TX
    ZIP 75056
  • Facility Phone: 214 695-6273
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: HOLLY WYSOWSKI
  • NPI Number: 1841840758
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2181111
LAB Type Ambulatory Surgery Center
Facility Name GULFSTREAM PARC ASC, LLC
Street 3716 STANDRIDGE DR SUITE 100
City THE COLONY
State TX
ZIP 75056
Phone 214 695-6273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2024
Certificate Expiration Date 3/25/2026
Facility Type Ambulatory Surgery Center
Lab Director HOLLY WYSOWSKI

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