10D2131027 CLIA NUMBER - GULFSTREAM UROLOGY

Laboratory Demographics

  • CLIA Code: 10D2131027
  • Facility Name: GULFSTREAM UROLOGY
  • Facility Address: 14320 METROPOLIS AVE STE 1
    FORT MYERS, FL
    ZIP 33912
  • Facility Phone: 239 223-0342
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MEIR DALLER
  • NPI Number: 1255722203
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 10D2131027
LAB Type Physician Office
Facility Name GULFSTREAM UROLOGY
Street 14320 METROPOLIS AVE STE 1
City FORT MYERS
State FL
ZIP 33912
Phone 239 223-0342
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Physician Office
Lab Director MEIR DALLER

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