10D1089720 CLIA NUMBER - TREASURE COAST SURGICAL CENTER INC

Laboratory Demographics

CLIA Number: 10D1089720

Facility Name: TREASURE COAST SURGICAL CENTER INC

Facility Address:
1811 S 25TH ST
FORT PIERCE, FL
ZIP 34947
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Facility Phone Number: 772 467-1960

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1124296173

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1089720
LAB Type	Ambulatory Surgery Center
Facility Name	TREASURE COAST SURGICAL CENTER INC
Street	1811 S 25TH ST
City	FORT PIERCE
State	FL
ZIP	34947
Phone	772 467-1960
CertificateType	4
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	Waiver

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