10D2063500 CLIA NUMBER - SURGCENTER OF PALM BEACH GARDENS LLC

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Laboratory Demographics

CLIA Number: 10D2063500

Facility Name: SURGCENTER OF PALM BEACH GARDENS LLC

Facility Address:
900 VILLAGE SQ CROSSING STE 100
PALM BEACH GARDENS, FL
ZIP 33410
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Facility Phone Number: 561 429-6880

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1770929044

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2063500
LAB Type	Ambulatory Surgery Center
Facility Name	SURGCENTER OF PALM BEACH GARDENS LLC
Street	900 VILLAGE SQ CROSSING STE 100
City	PALM BEACH GARDENS
State	FL
ZIP	33410
Phone	561 429-6880
CertificateType	4
CertificateEffectiveDate	8/5/2023
CertificateExpirationDate	8/4/2025
FacilityType	Waiver

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