45D2275802 CLIA NUMBER - WILLIS SURGERY CENTER

Laboratory Demographics

CLIA Number: 45D2275802

Facility Name: WILLIS SURGERY CENTER

Facility Address:
9863 FM 1097 RD W
WILLIS, TX
ZIP 77318
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Facility Phone Number: 936 228-8955

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1639804248

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2275802
LAB Type	Ambulatory Surgery Center
Facility Name	WILLIS SURGERY CENTER
Street	9863 FM 1097 RD W
City	WILLIS
State	TX
ZIP	77318
Phone	936 228-8955
CertificateType	4
CertificateEffectiveDate	1/27/2023
CertificateExpirationDate	1/26/2025
FacilityType	Waiver

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