10D1026431 CLIA NUMBER - PEDIATRIC SURGERY CENTERS LLC

Laboratory Demographics

CLIA Number: 10D1026431

Facility Name: PEDIATRIC SURGERY CENTERS LLC

Facility Address:
10080 BALAYE RUN DRIVE
TAMPA, FL
ZIP 33619
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Facility Phone Number: 813 490-6100

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1689664906

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1026431
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	PEDIATRIC SURGERY CENTERS LLC
Street	10080 BALAYE RUN DRIVE
City	TAMPA
State	FL
ZIP	33619
Phone	813 490-6100
CertificateType	4
CertificateEffectiveDate	6/4/2022
CertificateExpirationDate	6/3/2024
FacilityType	Waiver

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