10D1079845 CLIA NUMBER - TLC ASC LLC DBA TLC OUTPATIENT SURGERY AND LASER CENTER

Laboratory Demographics

  • CLIA Code: 10D1079845
  • Facility Name: TLC ASC LLC DBA TLC OUTPATIENT SURGERY AND LASER CENTER
  • Facility Address: 201 W GUAVA ST
    LADY LAKE, FL
    ZIP 32159
  • Facility Phone: 407 381-2505
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DINO MADONNA
  • NPI Number: 1285815522
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1079845
LAB Type Ambulatory Surgery Center
Facility Name TLC ASC LLC DBA TLC OUTPATIENT SURGERY AND LASER CENTER
Street 201 W GUAVA ST
City LADY LAKE
State FL
ZIP 32159
Phone 407 381-2505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Ambulatory Surgery Center
Lab Director DINO MADONNA

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This page was last updated on: 6/4/2025