10D2217326 CLIA NUMBER - ADVENTHEALTH SURGERY CENTER WELLSWOOD, LLC

Laboratory Demographics

CLIA Number: 10D2217326

Facility Name: ADVENTHEALTH SURGERY CENTER WELLSWOOD, LLC

Facility Address:
5013 N ARMENIA AVE
TAMPA, FL
ZIP 33603
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Facility Phone Number: 813 875-0562

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1588260343

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2217326
LAB Type	Ambulatory Surgery Center
Facility Name	ADVENTHEALTH SURGERY CENTER WELLSWOOD, LLC
Street	5013 N ARMENIA AVE
City	TAMPA
State	FL
ZIP	33603
Phone	813 875-0562
CertificateType	4
CertificateEffectiveDate	3/19/2023
CertificateExpirationDate	3/18/2025
FacilityType	Waiver

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