10D1052744 CLIA NUMBER - PARKCREEK ASC, LLC DBA PARKCREEK SURGERY CENTER

Laboratory Demographics

CLIA Number: 10D1052744

Facility Name: PARKCREEK ASC, LLC DBA PARKCREEK SURGERY CENTER

Facility Address:
6806 N STATE RD 7
COCONUT CREEK, FL
ZIP 33073
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Facility Phone Number: 954 312-3501

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1467405837

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1052744
LAB Type	Ambulatory Surgery Center
Facility Name	PARKCREEK ASC, LLC DBA PARKCREEK SURGERY CENTER
Street	6806 N STATE RD 7
City	COCONUT CREEK
State	FL
ZIP	33073
Phone	954 312-3501
CertificateType	4
CertificateEffectiveDate	4/3/2024
CertificateExpirationDate	4/2/2026
FacilityType	Waiver

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