# INNOVATION SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003544198
- **Authorized official:** LISA COX (ADMINISTRATOR)
- **Authorized official phone:** (303) 332-4170

## Contact information

- **Practice address:** 836 S ANGEL ST STE 103, LAYTON, UT 84041-3687
- **Practice address phone:** (303) 332-4170
- **Mailing address:** 2201 FM 1339, KINGSBURY, TX 78638-1112
- **Mailing address phone:** (303) 332-4170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/08/2022
- **Last updated:** 10/17/2022