10D2177418 CLIA NUMBER - SPECIALIZED OUTPATIENT SURGERY CENTER FOR CHILDREN AND ADULTS, LLC

Laboratory Demographics

CLIA Number: 10D2177418

Facility Name: SPECIALIZED OUTPATIENT SURGERY CENTER FOR CHILDREN AND ADULTS, LLC

Facility Address:
10150 HAGEN RANCH ROAD SUITE 204
BOYNTON BEACH, FL
ZIP 33437
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Facility Phone Number: 561 630-6277

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1427558576

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2177418
LAB Type	Ambulatory Surgery Center
Facility Name	SPECIALIZED OUTPATIENT SURGERY CENTER FOR CHILDREN AND ADULTS, LLC
Street	10150 HAGEN RANCH ROAD SUITE 204
City	BOYNTON BEACH
State	FL
ZIP	33437
Phone	561 630-6277
CertificateType	4
CertificateEffectiveDate	1/10/2024
CertificateExpirationDate	1/9/2026
FacilityType	Waiver

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