10D2150176 CLIA NUMBER - SKYWAY SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 10D2150176

Facility Name: SKYWAY SURGERY CENTER, LLC

Facility Address:
625 6TH AVENUE SOUTH STE 150
SAINT PETERSBURG, FL
ZIP 33701
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Facility Phone Number: 727 440-4888

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1366935074

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2150176
LAB Type	Ambulatory Surgery Center
Facility Name	SKYWAY SURGERY CENTER, LLC
Street	625 6TH AVENUE SOUTH STE 150
City	SAINT PETERSBURG
State	FL
ZIP	33701
Phone	727 440-4888
CertificateType	4
CertificateEffectiveDate	6/19/2022
CertificateExpirationDate	6/18/2024
FacilityType	Waiver

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