10D1093147 CLIA NUMBER - PHYSICIANS OUTPATIENT SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 10D1093147

Facility Name: PHYSICIANS OUTPATIENT SURGERY CENTER LLC

Facility Address:
1000 NE 56TH ST 2ND FL
OAKLAND PARK, FL
ZIP 33334
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Facility Phone Number: 954 229-8617

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1235393356

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1093147
LAB Type	Ambulatory Surgery Center
Facility Name	PHYSICIANS OUTPATIENT SURGERY CENTER LLC
Street	1000 NE 56TH ST 2ND FL
City	OAKLAND PARK
State	FL
ZIP	33334
Phone	954 229-8617
CertificateType	4
CertificateEffectiveDate	12/11/2022
CertificateExpirationDate	12/10/2024
FacilityType	Waiver

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