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10D2135007 CLIA NUMBER - FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE

Laboratory Demographics

CLIA Number: 10D2135007

Facility Name: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE

Facility Address:
1030 COMMERCE CREEK BLVD
CAPE CORAL, FL
ZIP 33909
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Facility Phone Number: 813 875-3995

Facility Type: Other - NUCLEAR MED HOTLAB

Certificate Type: Waiver
NPI Number: 1700306388

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 10D2135007
LAB Type Other - NUCLEAR MED HOTLAB
Facility Name FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE
Street 1030 COMMERCE CREEK BLVD
City CAPE CORAL
State FL
ZIP 33909
Phone 813 875-3995
CertificateType 4
CertificateEffectiveDate 8/14/2023
CertificateExpirationDate 8/13/2025
FacilityType Waiver

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