10D1105071 CLIA NUMBER - TAMPA SURGERY CENTER

Laboratory Demographics

CLIA Number: 10D1105071

Facility Name: TAMPA SURGERY CENTER

Facility Address:
13904 N DALE MABRY HWY STE 100
TAMPA, FL
ZIP 33618
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Facility Phone Number: 813 397-1692

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1023256187

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1105071
LAB Type	Ambulatory Surgery Center
Facility Name	TAMPA SURGERY CENTER
Street	13904 N DALE MABRY HWY STE 100
City	TAMPA
State	FL
ZIP	33618
Phone	813 397-1692
CertificateType	4
CertificateEffectiveDate	9/15/2023
CertificateExpirationDate	9/14/2025
FacilityType	Waiver

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