10D0908302 CLIA NUMBER - AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 10D0908302
  • Facility Name: AMBULATORY SURGERY CENTER
  • Facility Address: 4500 E FLETCHER AVE
    TAMPA, FL
    ZIP 33613
  • Facility Phone: 813 977-8550
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: YENEISY GONZALEZ
  • NPI Number: 1629032446
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0908302
LAB Type Ambulatory Surgery Center
Facility Name AMBULATORY SURGERY CENTER
Street 4500 E FLETCHER AVE
City TAMPA
State FL
ZIP 33613
Phone 813 977-8550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Ambulatory Surgery Center
Lab Director YENEISY GONZALEZ

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