10D2160844 CLIA NUMBER - TAMPA CHILDREN'S SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 10D2160844

Facility Name: TAMPA CHILDREN'S SURGERY CENTER LLC

Facility Address:
10909 W LINEBAUGH AVE
TAMPA, FL
ZIP 33626
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Facility Phone Number: 813 774-6003

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1215421540

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2160844
LAB Type	Ambulatory Surgery Center
Facility Name	TAMPA CHILDREN'S SURGERY CENTER LLC
Street	10909 W LINEBAUGH AVE
City	TAMPA
State	FL
ZIP	33626
Phone	813 774-6003
CertificateType	4
CertificateEffectiveDate	1/18/2023
CertificateExpirationDate	1/17/2025
FacilityType	Waiver

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