10D1020781 CLIA NUMBER - BAYSIDE AMBULATORY CENTER LLC DBA BAYSIDE AMBULATORY CENTER

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Laboratory Demographics

CLIA Number: 10D1020781

Facility Name: BAYSIDE AMBULATORY CENTER LLC DBA BAYSIDE AMBULATORY CENTER

Facility Address:
3641 S MIAMI AVE 4TH FL
MIAMI, FL
ZIP 33133
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Facility Phone Number: 305 854-3636

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1023036688

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1020781
LAB Type	Ambulatory Surgery Center
Facility Name	BAYSIDE AMBULATORY CENTER LLC DBA BAYSIDE AMBULATORY CENTER
Street	3641 S MIAMI AVE 4TH FL
City	MIAMI
State	FL
ZIP	33133
Phone	305 854-3636
CertificateType	4
CertificateEffectiveDate	1/5/2024
CertificateExpirationDate	1/4/2026
FacilityType	Waiver

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