10D0945550 CLIA NUMBER - CITRUS ENDOSCOPY AND SURGERY CENTER

Laboratory Demographics

CLIA Number: 10D0945550

Facility Name: CITRUS ENDOSCOPY AND SURGERY CENTER

Facility Address:
6412 W GULF TO LAKE HWY
CRYSTAL RIVER, FL
ZIP 34429
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Facility Phone Number: 352 563-0223

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1952373086

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0945550
LAB Type	Ambulatory Surgery Center
Facility Name	CITRUS ENDOSCOPY AND SURGERY CENTER
Street	6412 W GULF TO LAKE HWY
City	CRYSTAL RIVER
State	FL
ZIP	34429
Phone	352 563-0223
CertificateType	4
CertificateEffectiveDate	5/5/2024
CertificateExpirationDate	5/4/2026
FacilityType	Waiver

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