10D1032076 CLIA NUMBER - SOUTHEASTERN OUTPATIENT SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 10D1032076
  • Facility Name: SOUTHEASTERN OUTPATIENT SURGERY CENTER
  • Facility Address: 2030 FLEISCHMANN RD
    TALLAHASSEE, FL
    ZIP 32308
  • Facility Phone: 850 219-2000
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BEN J. KIRBO MD
  • NPI Number: 1033223367
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1032076
LAB Type Ambulatory Surgery Center
Facility Name SOUTHEASTERN OUTPATIENT SURGERY CENTER
Street 2030 FLEISCHMANN RD
City TALLAHASSEE
State FL
ZIP 32308
Phone 850 219-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2024
Certificate Expiration Date 10/17/2026
Facility Type Ambulatory Surgery Center
Lab Director BEN J. KIRBO MD

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This page was last updated on: 9/29/2025