10D0907936 CLIA NUMBER - PALM BEACH OUTPATIENT SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 10D0907936
  • Facility Name: PALM BEACH OUTPATIENT SURGICAL CENTER
  • Facility Address: 2889 10TH AVE NORTH SUITE 203
    LAKE WORTH, FL
    ZIP 33461
  • Facility Phone: 561 576-8436
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MADONNA W. COFFMAN
  • NPI Number: 1699349159
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0907936
LAB Type Ambulatory Surgery Center
Facility Name PALM BEACH OUTPATIENT SURGICAL CENTER
Street 2889 10TH AVE NORTH SUITE 203
City LAKE WORTH
State FL
ZIP 33461
Phone 561 576-8436
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Ambulatory Surgery Center
Lab Director MADONNA W. COFFMAN

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