10D2107599 CLIA NUMBER - SPECIALTY RETINA CENTER SPORT & ORTHOPEDIC CENTER

Laboratory Demographics

  • CLIA Code: 10D2107599
  • Facility Name: SPECIALTY RETINA CENTER SPORT & ORTHOPEDIC CENTER
  • Facility Address: 2001 W SAMPLE RD STE 320 & 322
    DEERFIELD BEACH, FL
    ZIP 33064
  • Facility Phone: 561 322-3588
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SHAILESH GUPTA
  • NPI Number: 1326548942
  • Taxonomy: 261QS0132X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2107599
LAB Type Physician Office
Facility Name SPECIALTY RETINA CENTER SPORT & ORTHOPEDIC CENTER
Street 2001 W SAMPLE RD STE 320 & 322
City DEERFIELD BEACH
State FL
ZIP 33064
Phone 561 322-3588
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Physician Office
Lab Director DR. SHAILESH GUPTA

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