10D2179691 CLIA NUMBER - WHITE SANDS OUTPATIENT SERVICES (WSOP SERVICES LLC

Laboratory Demographics

CLIA Number: 10D2179691

Facility Name: WHITE SANDS OUTPATIENT SERVICES (WSOP SERVICES LLC

Facility Address:
1820 COLONIAL BLVD
FORT MYERS, FL
ZIP 33907
Get Directions

Facility Phone Number: 239 895-0610

Facility Type: Other - OUTPATIENT SUBSTANCE ABUS

Certificate Type: Waiver

NPI Number: 1932515889

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	10D2179691
LAB Type	Other - OUTPATIENT SUBSTANCE ABUS
Facility Name	WHITE SANDS OUTPATIENT SERVICES (WSOP SERVICES LLC
Street	1820 COLONIAL BLVD
City	FORT MYERS
State	FL
ZIP	33907
Phone	239 895-0610
CertificateType	4
CertificateEffectiveDate	2/29/2024
CertificateExpirationDate	2/27/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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