10D1088107 CLIA NUMBER - CORAL RIDGE OUTPATIENT CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D1088107
  • Facility Name: CORAL RIDGE OUTPATIENT CENTER LLC
  • Facility Address: 5301 N DIXIE HWY STE 100
    OAKLAND PARK, FL
    ZIP 33308
  • Facility Phone: 561 397-7910
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOHN D. BLOOM JR
  • NPI Number: 1689794505
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 10D1088107
LAB Type Ambulatory Surgery Center
Facility Name CORAL RIDGE OUTPATIENT CENTER LLC
Street 5301 N DIXIE HWY STE 100
City OAKLAND PARK
State FL
ZIP 33308
Phone 561 397-7910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2024
Certificate Expiration Date 8/17/2026
Facility Type Ambulatory Surgery Center
Lab Director JOHN D. BLOOM JR

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This page was last updated on: 9/29/2025