45D2185135 CLIA NUMBER - MAPLESHADE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 45D2185135
  • Facility Name: MAPLESHADE SURGERY CENTER
  • Facility Address: 960 OHIO DR SUITE 100
    PLANO, TX
    ZIP 75093
  • Facility Phone: 972 599-1447
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: XINGING FAN
  • NPI Number: 1235789041
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2185135
LAB Type Ambulatory Surgery Center
Facility Name MAPLESHADE SURGERY CENTER
Street 960 OHIO DR SUITE 100
City PLANO
State TX
ZIP 75093
Phone 972 599-1447
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Ambulatory Surgery Center
Lab Director XINGING FAN

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