10D2240581 CLIA NUMBER - GAINESVILLE PLASTIC SURGERY ASSOCIATES, PL

Laboratory Demographics

CLIA Number: 10D2240581

Facility Name: GAINESVILLE PLASTIC SURGERY ASSOCIATES, PL

Facility Address:
6801 NW 9TH BLVD, STE 2
GAINESVILLE, FL
ZIP 32605
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Facility Phone Number: 352 331-3401

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1659567303

Taxonomy: 2086S0122X - Surgery
A surgeon who specializes in plastic and reconstructive surgery.

CLIA Record

Field Name	Field Value
CLIA Number	10D2240581
LAB Type	Physician Office
Facility Name	GAINESVILLE PLASTIC SURGERY ASSOCIATES, PL
Street	6801 NW 9TH BLVD, STE 2
City	GAINESVILLE
State	FL
ZIP	32605
Phone	352 331-3401
CertificateType	4
CertificateEffectiveDate	10/20/2023
CertificateExpirationDate	10/19/2025
FacilityType	Waiver

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