10D1088107 CLIA NUMBER - CORAL RIDGE OUTPATIENT CENTER LLC

Laboratory Demographics

CLIA Number: 10D1088107

Facility Name: CORAL RIDGE OUTPATIENT CENTER LLC

Facility Address:
5301 N DIXIE HWY STE 100
OAKLAND PARK, FL
ZIP 33308
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Facility Phone Number: 561 397-7910

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1689794505

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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
CertificateType	4
CertificateEffectiveDate	8/18/2022
CertificateExpirationDate	8/17/2024
FacilityType	Waiver

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