10D1078858 CLIA NUMBER - FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC

Laboratory Demographics

CLIA Number: 10D1078858

Facility Name: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC

Facility Address:
5985 SILVER FALLS RUN SUITE 200
BRADENTON, FL
ZIP 34211
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Facility Phone Number: 941 907-4737

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1063054153

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	10D1078858
LAB Type	Physician Office
Facility Name	FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC
Street	5985 SILVER FALLS RUN SUITE 200
City	BRADENTON
State	FL
ZIP	34211
Phone	941 907-4737
CertificateType	1
CertificateEffectiveDate	3/14/2024
CertificateExpirationDate	3/13/2026
FacilityType	Accreditation

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