45D2329835 CLIA NUMBER - BRAZOS VALLEY PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 45D2329835
  • Facility Name: BRAZOS VALLEY PLASTIC SURGERY
  • Facility Address: 2809 EARL RUDDER FWY S, STE 101
    COLLEGE STATION, TX
    ZIP 77845
  • Facility Phone: 979 776-8825
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MALCOLM J. RUDE
  • NPI Number: 1689006728
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2329835
LAB Type Ambulatory Surgery Center
Facility Name BRAZOS VALLEY PLASTIC SURGERY
Street 2809 EARL RUDDER FWY S, STE 101
City COLLEGE STATION
State TX
ZIP 77845
Phone 979 776-8825
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2025
Certificate Expiration Date 9/4/2027
Facility Type Ambulatory Surgery Center
Lab Director MALCOLM J. RUDE

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