10D2169391 CLIA NUMBER - LAKEWOOD ASC, LLC

Laboratory Demographics

  • CLIA Code: 10D2169391
  • Facility Name: LAKEWOOD ASC, LLC
  • Facility Address: 5571 E SR 44 SUITE 501
    WILDWOOD, FL
    ZIP 34785
  • Facility Phone: 352 643-9070
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Certificate of Compliance
  • Lab Director: VINOD MIRYALA
  • NPI Number: 1821565706
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2169391
LAB Type Ambulatory Surgery Center
Facility Name LAKEWOOD ASC, LLC
Street 5571 E SR 44 SUITE 501
City WILDWOOD
State FL
ZIP 34785
Phone 352 643-9070
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/14/2024
Certificate Expiration Date 7/13/2026
Facility Type Ambulatory Surgery Center
Lab Director VINOD MIRYALA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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