45D2197113 CLIA NUMBER - PARK PLACE HEALTH CARE CENTER

Laboratory Demographics

  • CLIA Code: 45D2197113
  • Facility Name: PARK PLACE HEALTH CARE CENTER
  • Facility Address: 121 FM 971
    GEORGETOWN, TX
    ZIP 78626
  • Facility Phone: 314 258-1037
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RANDY RONQUILLO
  • NPI Number: 1578956355
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2197113
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PARK PLACE HEALTH CARE CENTER
Street 121 FM 971
City GEORGETOWN
State TX
ZIP 78626
Phone 314 258-1037
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2024
Certificate Expiration Date 10/20/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director RANDY RONQUILLO

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