10D2179292 CLIA NUMBER - JHS SURGICAL PAVILLION, LLC

Laboratory Demographics

  • CLIA Code: 10D2179292
  • Facility Name: JHS SURGICAL PAVILLION, LLC
  • Facility Address: 3319 S STATE ROAD 7 SUITE 105
    WELLINGTON, FL
    ZIP 33449
  • Facility Phone: 561 557-3115
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARIO RUEDA
  • NPI Number: 1720619927
  • Taxonomy: 2082S0105X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2179292
LAB Type Ambulatory Surgery Center
Facility Name JHS SURGICAL PAVILLION, LLC
Street 3319 S STATE ROAD 7 SUITE 105
City WELLINGTON
State FL
ZIP 33449
Phone 561 557-3115
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2024
Certificate Expiration Date 2/18/2026
Facility Type Ambulatory Surgery Center
Lab Director MARIO RUEDA

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