10D1066283 CLIA NUMBER - ANDREWS INSTITUTE ASC LLC

Laboratory Demographics

CLIA Number: 10D1066283

Facility Name: ANDREWS INSTITUTE ASC LLC

Facility Address:
1040 GULF BREEZE PARKWAY STE 100
GULF BREEZE, FL
ZIP 32561
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Facility Phone Number: 850 916-8500

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1104907328

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1066283
LAB Type	Ambulatory Surgery Center
Facility Name	ANDREWS INSTITUTE ASC LLC
Street	1040 GULF BREEZE PARKWAY STE 100
City	GULF BREEZE
State	FL
ZIP	32561
Phone	850 916-8500
CertificateType	4
CertificateEffectiveDate	3/21/2023
CertificateExpirationDate	3/20/2025
FacilityType	Waiver

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