10D2217060 CLIA NUMBER - ADVANCED ENDOVASCULAR INSTITUTE

Laboratory Demographics

  • CLIA Code: 10D2217060
  • Facility Name: ADVANCED ENDOVASCULAR INSTITUTE
  • Facility Address: 1301 PLANTATION ISLAND DR S STE 401
    SAINT AUGUSTINE, FL
    ZIP 32080
  • Facility Phone: 262 443-0630
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IMRAAN ANSAARIE
  • NPI Number: 1497361943
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2217060
LAB Type Physician Office
Facility Name ADVANCED ENDOVASCULAR INSTITUTE
Street 1301 PLANTATION ISLAND DR S STE 401
City SAINT AUGUSTINE
State FL
ZIP 32080
Phone 262 443-0630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Physician Office
Lab Director IMRAAN ANSAARIE

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