10D0907064 CLIA NUMBER - LAKE SURGERY & ENDOSCOPY CENTER

Laboratory Demographics

CLIA Number: 10D0907064

Facility Name: LAKE SURGERY & ENDOSCOPY CENTER

Facility Address:
8110 CR 44 LEG A
LEESBURG, FL
ZIP 34788
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Facility Phone Number: 352 323-1995

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1235165531

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0907064
LAB Type	Ambulatory Surgery Center
Facility Name	LAKE SURGERY & ENDOSCOPY CENTER
Street	8110 CR 44 LEG A
City	LEESBURG
State	FL
ZIP	34788
Phone	352 323-1995
CertificateType	4
CertificateEffectiveDate	10/7/2023
CertificateExpirationDate	10/6/2025
FacilityType	Waiver

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