45D2290024 CLIA NUMBER - GLENEAGLES SURGERY CENTER INC

Laboratory Demographics

  • CLIA Code: 45D2290024
  • Facility Name: GLENEAGLES SURGERY CENTER INC
  • Facility Address: 2633 DALLAS PKWY STE 202
    PLANO, TX
    ZIP 75093
  • Facility Phone: 972 403-7733
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JEREMIAH GRAFF
  • NPI Number: 1255000329
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2290024
LAB Type Ambulatory Surgery Center
Facility Name GLENEAGLES SURGERY CENTER INC
Street 2633 DALLAS PKWY STE 202
City PLANO
State TX
ZIP 75093
Phone 972 403-7733
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2025
Certificate Expiration Date 9/18/2027
Facility Type Ambulatory Surgery Center
Lab Director JEREMIAH GRAFF

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