45D2200077 CLIA NUMBER - ENCORE ASC, LLC

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Laboratory Demographics

CLIA Number: 45D2200077

Facility Name: ENCORE ASC, LLC

Facility Address:
2200 PHYSICIANS BLVD STE A
ENNIS, TX
ZIP 75119
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Facility Phone Number: 972 945-5800

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1831714419

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2200077
LAB Type	Ambulatory Surgery Center
Facility Name	ENCORE ASC, LLC
Street	2200 PHYSICIANS BLVD STE A
City	ENNIS
State	TX
ZIP	75119
Phone	972 945-5800
CertificateType	4
CertificateEffectiveDate	11/13/2022
CertificateExpirationDate	11/12/2024
FacilityType	Waiver

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