10D2062883 CLIA NUMBER - FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE LLC

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Laboratory Demographics

CLIA Number: 10D2062883

Facility Name: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE LLC

Facility Address:
6420 W NEWBERRY RD, EAST WING STE 200
GAINESVILLE, FL
ZIP 32605
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Facility Phone Number: 813 875-3993

Facility Type: Other - NUCLEAR MEDICINE HEALTH

Certificate Type: Waiver

NPI Number: 1487961116

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	10D2062883
LAB Type	Other - NUCLEAR MEDICINE HEALTH
Facility Name	FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE LLC
Street	6420 W NEWBERRY RD, EAST WING STE 200
City	GAINESVILLE
State	FL
ZIP	32605
Phone	813 875-3993
CertificateType	4
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	Waiver

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