10D1084032 CLIA NUMBER - BRADENTON SURGERY CENTER INC

Laboratory Demographics

CLIA Number: 10D1084032

Facility Name: BRADENTON SURGERY CENTER INC

Facility Address:
2902 59TH ST W SUITES F & G
BRADENTON, FL
ZIP 34209
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Facility Phone Number: 941 792-9685

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1508822685

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D1084032
LAB Type	Ambulatory Surgery Center
Facility Name	BRADENTON SURGERY CENTER INC
Street	2902 59TH ST W SUITES F & G
City	BRADENTON
State	FL
ZIP	34209
Phone	941 792-9685
CertificateType	4
CertificateEffectiveDate	5/15/2022
CertificateExpirationDate	5/14/2024
FacilityType	Waiver

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