10D0293855 CLIA NUMBER - GENESISCARE USA OF FLORIDA,LLC

Laboratory Demographics

CLIA Number: 10D0293855

Facility Name: GENESISCARE USA OF FLORIDA,LLC

Facility Address:
7341 GLADIOLUS DR
FORT MYERS, FL
ZIP 33908
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Facility Phone Number: 239 489-3420

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134109747

Taxonomy: 2085R0001X - Radiology
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

CLIA Record

Field Name	Field Value
CLIA Number	10D0293855
LAB Type	Physician Office
Facility Name	GENESISCARE USA OF FLORIDA,LLC
Street	7341 GLADIOLUS DR
City	FORT MYERS
State	FL
ZIP	33908
Phone	239 489-3420
CertificateType	4
CertificateEffectiveDate	1/19/2024
CertificateExpirationDate	1/18/2026
FacilityType	Waiver

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