10D1016911 CLIA NUMBER - CITRUS AMBULATORY SURGERY CTR

Laboratory Demographics

CLIA Number: 10D1016911

Facility Name: CITRUS AMBULATORY SURGERY CTR

Facility Address:
2861 S DELANEY AVE STE B
ORLANDO, FL
ZIP 32806
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Facility Phone Number: 407 472-5095

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1376518357

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1016911
LAB Type	Ambulatory Surgery Center
Facility Name	CITRUS AMBULATORY SURGERY CTR
Street	2861 S DELANEY AVE STE B
City	ORLANDO
State	FL
ZIP	32806
Phone	407 472-5095
CertificateType	4
CertificateEffectiveDate	9/11/2023
CertificateExpirationDate	9/10/2025
FacilityType	Waiver

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