10D2133840 CLIA NUMBER - FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE

Laboratory Demographics

CLIA Number: 10D2133840

Facility Name: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE

Facility Address:
8260 GLADIOLUS DRIVE
FORT MYERS, FL
ZIP 33908
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Facility Phone Number: 813 875-3995

Facility Type: Other - NUCLEAR MED HOTLAB

Certificate Type: Waiver

NPI Number: 1225064520

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	10D2133840
LAB Type	Other - NUCLEAR MED HOTLAB
Facility Name	FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE
Street	8260 GLADIOLUS DRIVE
City	FORT MYERS
State	FL
ZIP	33908
Phone	813 875-3995
CertificateType	4
CertificateEffectiveDate	7/20/2023
CertificateExpirationDate	7/19/2025
FacilityType	Waiver

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