10D2011335 CLIA NUMBER - COLONIAL OUTPATIENT SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2011335
  • Facility Name: COLONIAL OUTPATIENT SURGERY CENTER LLC
  • Facility Address: 4571 COLONIAL BLVD #200
    FORT MYERS, FL
    ZIP 33966
  • Facility Phone: 239 333-2560
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PETER CURCIONE
  • NPI Number: 1669642641
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 10D2011335
LAB Type Ambulatory Surgery Center
Facility Name COLONIAL OUTPATIENT SURGERY CENTER LLC
Street 4571 COLONIAL BLVD #200
City FORT MYERS
State FL
ZIP 33966
Phone 239 333-2560
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Ambulatory Surgery Center
Lab Director PETER CURCIONE

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