10D0925298 CLIA NUMBER - LAKE CITY SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 10D0925298

Facility Name: LAKE CITY SURGERY CENTER LLC

Facility Address:
208 SW PROSPERITY PLACE
LAKE CITY, FL
ZIP 32024
Get Directions

Facility Phone Number: 386 487-3930

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1598965634

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0925298
LAB Type	Ambulatory Surgery Center
Facility Name	LAKE CITY SURGERY CENTER LLC
Street	208 SW PROSPERITY PLACE
City	LAKE CITY
State	FL
ZIP	32024
Phone	386 487-3930
CertificateType	4
CertificateEffectiveDate	5/10/2022
CertificateExpirationDate	5/9/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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