10D0974653 CLIA NUMBER - FLORIDA ENDOSCOPY & SURGERU CTR LLC

Laboratory Demographics

CLIA Number: 10D0974653

Facility Name: FLORIDA ENDOSCOPY & SURGERU CTR LLC

Facility Address:
12900 CORTEZ BLVD SUITE 103 1ST FLOOR
BROOKSVILLE, FL
ZIP 34613
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Facility Phone Number: 352 596-1145

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1568437820

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0974653
LAB Type	Ambulatory Surgery Center
Facility Name	FLORIDA ENDOSCOPY & SURGERU CTR LLC
Street	12900 CORTEZ BLVD SUITE 103 1ST FLOOR
City	BROOKSVILLE
State	FL
ZIP	34613
Phone	352 596-1145
CertificateType	4
CertificateEffectiveDate	6/13/2022
CertificateExpirationDate	6/12/2024
FacilityType	Waiver

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