10D2005576 CLIA NUMBER - COASTAL SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 10D2005576
  • Facility Name: COASTAL SURGERY CENTER
  • Facility Address: 4147 SOUTHPOINT DR E
    JACKSONVILLE, FL
    ZIP 32216
  • Facility Phone: 904 332-6774
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TIMOTHY E. FEE
  • NPI Number: 1902832405
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2005576
LAB Type Ambulatory Surgery Center
Facility Name COASTAL SURGERY CENTER
Street 4147 SOUTHPOINT DR E
City JACKSONVILLE
State FL
ZIP 32216
Phone 904 332-6774
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2024
Certificate Expiration Date 3/30/2026
Facility Type Ambulatory Surgery Center
Lab Director TIMOTHY E. FEE

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