10D2004112 CLIA NUMBER - PALM BEACH GENERAL SURGEON THE CENTER FOR ADVANCED SURGICAL CARE

Laboratory Demographics

  • CLIA Code: 10D2004112
  • Facility Name: PALM BEACH GENERAL SURGEON THE CENTER FOR ADVANCED SURGICAL CARE
  • Facility Address: 5503 S CONGRESS AVENUE SUITE 206
    ATLANTIS, FL
    ZIP 33462
  • Facility Phone: 561 964-1632
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH A. LARSON
  • NPI Number: 1649218561
  • Taxonomy: 207T00000X - Neurological Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2004112
LAB Type Physician Office
Facility Name PALM BEACH GENERAL SURGEON THE CENTER FOR ADVANCED SURGICAL CARE
Street 5503 S CONGRESS AVENUE SUITE 206
City ATLANTIS
State FL
ZIP 33462
Phone 561 964-1632
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2024
Certificate Expiration Date 2/24/2026
Facility Type Physician Office
Lab Director KENNETH A. LARSON

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