10D2162129 CLIA NUMBER - MIDDLEBURG SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2162129
  • Facility Name: MIDDLEBURG SURGERY CENTER LLC
  • Facility Address: 1821 BLANDING BLVD STE 2
    MIDDLEBURG, FL
    ZIP 32068
  • Facility Phone: 904 264-0400
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: WOLF RACHEL
  • NPI Number: 1558844183
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2162129
LAB Type Ambulatory Surgery Center
Facility Name MIDDLEBURG SURGERY CENTER LLC
Street 1821 BLANDING BLVD STE 2
City MIDDLEBURG
State FL
ZIP 32068
Phone 904 264-0400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2025
Certificate Expiration Date 2/18/2027
Facility Type Ambulatory Surgery Center
Lab Director WOLF RACHEL

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