10D2071954 CLIA NUMBER - E TREVOR ELMQUIST DO PA

Laboratory Demographics

  • CLIA Code: 10D2071954
  • Facility Name: E TREVOR ELMQUIST DO PA
  • Facility Address: 7970 SUMMERLIN LAKES DR SUITE 200
    FORT MYERS, FL
    ZIP 33907
  • Facility Phone: 239 936-2020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KATE M. WAGNER
  • NPI Number: 1750437786
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 10D2071954
LAB Type Physician Office
Facility Name E TREVOR ELMQUIST DO PA
Street 7970 SUMMERLIN LAKES DR SUITE 200
City FORT MYERS
State FL
ZIP 33907
Phone 239 936-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2024
Certificate Expiration Date 1/21/2026
Facility Type Physician Office
Lab Director KATE M. WAGNER

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