10D2221996 CLIA NUMBER - DESTIN PLASTIC SURGERY CENTER INC

Laboratory Demographics

  • CLIA Code: 10D2221996
  • Facility Name: DESTIN PLASTIC SURGERY CENTER INC
  • Facility Address: 4485 FURLING LANE
    DESTIN, FL
    ZIP 32541
  • Facility Phone: 850 654-1194
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: WILLIAM BURDEN
  • NPI Number: 1174720874
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D2221996
LAB Type Ambulatory Surgery Center
Facility Name DESTIN PLASTIC SURGERY CENTER INC
Street 4485 FURLING LANE
City DESTIN
State FL
ZIP 32541
Phone 850 654-1194
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Ambulatory Surgery Center
Lab Director WILLIAM BURDEN

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