45D2280377 CLIA NUMBER - PSA AMBULATORY SURGERY CENTER OF SOUTH AUSTIN, PLLC

Laboratory Demographics

  • CLIA Code: 45D2280377
  • Facility Name: PSA AMBULATORY SURGERY CENTER OF SOUTH AUSTIN, PLLC
  • Facility Address: 701 E FM 1626 STE 300
    AUSTIN, TX
    ZIP 78748
  • Facility Phone: 512 953-8134
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GENARO GUTIERREZ
  • NPI Number: 1770223901
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2280377
LAB Type Ambulatory Surgery Center
Facility Name PSA AMBULATORY SURGERY CENTER OF SOUTH AUSTIN, PLLC
Street 701 E FM 1626 STE 300
City AUSTIN
State TX
ZIP 78748
Phone 512 953-8134
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Ambulatory Surgery Center
Lab Director GENARO GUTIERREZ

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This page was last updated on: 3/20/2025