10D2185163 CLIA NUMBER - ADVANCED SURGICAL CARE OF CLEARWATER LLC

Laboratory Demographics

CLIA Number: 10D2185163

Facility Name: ADVANCED SURGICAL CARE OF CLEARWATER LLC

Facility Address:
93 PARK PLACE BLVD SUITE 102
CLEARWATER, FL
ZIP 33759
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Facility Phone Number: 727 742-3564

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1154956928

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2185163
LAB Type	Ambulatory Surgery Center
Facility Name	ADVANCED SURGICAL CARE OF CLEARWATER LLC
Street	93 PARK PLACE BLVD SUITE 102
City	CLEARWATER
State	FL
ZIP	33759
Phone	727 742-3564
CertificateType	4
CertificateEffectiveDate	6/1/2022
CertificateExpirationDate	5/31/2024
FacilityType	Waiver

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