10D2046903 CLIA NUMBER - CORNERSTONE SURGICARE LLC

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Laboratory Demographics

CLIA Number: 10D2046903

Facility Name: CORNERSTONE SURGICARE LLC

Facility Address:
511 HEWITT ST
PENSACOLA, FL
ZIP 32503
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Facility Phone Number: 205 824-6250

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1033468442

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2046903
LAB Type	Ambulatory Surgery Center
Facility Name	CORNERSTONE SURGICARE LLC
Street	511 HEWITT ST
City	PENSACOLA
State	FL
ZIP	32503
Phone	205 824-6250
CertificateType	4
CertificateEffectiveDate	9/13/2022
CertificateExpirationDate	9/12/2024
FacilityType	Waiver

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