45D2274780 CLIA NUMBER - TEXARKANA AMBULATORY SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 45D2274780

Facility Name: TEXARKANA AMBULATORY SURGERY CENTER, LLC

Facility Address:
5950 SUMMERHILL RD, SUITE B
TEXARKANA, TX
ZIP 75503
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Facility Phone Number: 501 766-1065

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1205410651

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2274780
LAB Type	Ambulatory Surgery Center
Facility Name	TEXARKANA AMBULATORY SURGERY CENTER, LLC
Street	5950 SUMMERHILL RD, SUITE B
City	TEXARKANA
State	TX
ZIP	75503
Phone	501 766-1065
CertificateType	4
CertificateEffectiveDate	1/10/2023
CertificateExpirationDate	1/9/2025
FacilityType	Waiver

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