10D1064430 CLIA NUMBER - BRIAN K DOERR DPM PA

Laboratory Demographics

CLIA Number: 10D1064430

Facility Name: BRIAN K DOERR DPM PA

Facility Address:
14391 METROPOLIS AVE STE103
FORT MYERS, FL
ZIP 33912
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Facility Phone Number: 239 931-3668

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1437153236

Taxonomy: 213ES0103X - Podiatrist

CLIA Record

Field Name	Field Value
CLIA Number	10D1064430
LAB Type	Physician Office
Facility Name	BRIAN K DOERR DPM PA
Street	14391 METROPOLIS AVE STE103
City	FORT MYERS
State	FL
ZIP	33912
Phone	239 931-3668
CertificateType	4
CertificateEffectiveDate	2/23/2024
CertificateExpirationDate	2/22/2026
FacilityType	Waiver

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