10D2082985 CLIA NUMBER - ENDOCRINOLOGY INSTITUTE OF SOUTH FL LLC

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Laboratory Demographics

CLIA Number: 10D2082985

Facility Name: ENDOCRINOLOGY INSTITUTE OF SOUTH FL LLC

Facility Address:
4061 BONITA BEACH RD STE 101
BONITA SPRINGS, FL
ZIP 34134
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Facility Phone Number: 239 301-0110

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1366855975

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

CLIA Record

Field Name	Field Value
CLIA Number	10D2082985
LAB Type	Physician Office
Facility Name	ENDOCRINOLOGY INSTITUTE OF SOUTH FL LLC
Street	4061 BONITA BEACH RD STE 101
City	BONITA SPRINGS
State	FL
ZIP	34134
Phone	239 301-0110
CertificateType	4
CertificateEffectiveDate	8/26/2022
CertificateExpirationDate	8/25/2024
FacilityType	Waiver

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