10D2107803 CLIA NUMBER - FARAHMAND PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 10D2107803
  • Facility Name: FARAHMAND PLASTIC SURGERY
  • Facility Address: 12411 BRANTLEY COMMONS CT
    FORT MYERS, FL
    ZIP 33907
  • Facility Phone: 239 332-2388
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AUDREY E. FARAHMAND
  • NPI Number: 1669660890
  • Taxonomy: 208200000X - Plastic Surgery

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2107803
LAB Type Physician Office
Facility Name FARAHMAND PLASTIC SURGERY
Street 12411 BRANTLEY COMMONS CT
City FORT MYERS
State FL
ZIP 33907
Phone 239 332-2388
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 AUDREY E. FARAHMAND

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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