10D1056544 CLIA NUMBER - TRAILS EDGE SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D1056544
  • Facility Name: TRAILS EDGE SURGERY CENTER LLC
  • Facility Address: 28930 TRAILS EDGE BLVD STE 100
    BONITA SPRINGS, FL
    ZIP 34134
  • Facility Phone: (239) 495-4300
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ROLANDO RIVERA
  • NPI Number: 1639650161
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D1056544
LAB Type Ambulatory Surgery Center
Facility Name TRAILS EDGE SURGERY CENTER LLC
Street 28930 TRAILS EDGE BLVD STE 100
City BONITA SPRINGS
State FL
ZIP 34134
Phone 2394954300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2024
Certificate Expiration Date 7/18/2026
Facility Type Ambulatory Surgery Center
Lab Director ROLANDO RIVERA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 5/18/2026