10D0664257 CLIA NUMBER - PHYSICIANS SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 10D0664257
  • Facility Name: PHYSICIANS SURGERY CENTER, LLC
  • Facility Address: 4035 EVANS AVE
    FORT MYERS, FL
    ZIP 33901
  • Facility Phone: 239 788-0604
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: EUGENE MAHANEY
  • NPI Number: 1770588584
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0664257
LAB Type Ambulatory Surgery Center
Facility Name PHYSICIANS SURGERY CENTER, LLC
Street 4035 EVANS AVE
City FORT MYERS
State FL
ZIP 33901
Phone 239 788-0604
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ambulatory Surgery Center
Lab Director EUGENE MAHANEY

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