10D0971987 CLIA NUMBER - SUNCOAST SURGERY CENTER LLC

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Laboratory Demographics

CLIA Number: 10D0971987

Facility Name: SUNCOAST SURGERY CENTER LLC

Facility Address:
9617 GULF RESEARCH LANE
FORT MYERS, FL
ZIP 33912
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Facility Phone Number: 239 791-2273

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1043290653

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0971987
LAB Type	Ambulatory Surgery Center
Facility Name	SUNCOAST SURGERY CENTER LLC
Street	9617 GULF RESEARCH LANE
City	FORT MYERS
State	FL
ZIP	33912
Phone	239 791-2273
CertificateType	4
CertificateEffectiveDate	3/28/2024
CertificateExpirationDate	3/27/2026
FacilityType	Waiver

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