10D2103680 CLIA NUMBER - GARDNER PLASTIC SURGERY LLC

Laboratory Demographics

  • CLIA Code: 10D2103680
  • Facility Name: GARDNER PLASTIC SURGERY LLC
  • Facility Address: 1250 PINE RIDGE RD STE 101C
    NAPLES, FL
    ZIP 34108
  • Facility Phone: 239 566-2611
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: LEOPOLDO M. BACCARO
  • NPI Number: 1639317290
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2103680
LAB Type Ambulatory Surgery Center
Facility Name GARDNER PLASTIC SURGERY LLC
Street 1250 PINE RIDGE RD STE 101C
City NAPLES
State FL
ZIP 34108
Phone 239 566-2611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Ambulatory Surgery Center
Lab Director LEOPOLDO M. BACCARO

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