10D2278638 CLIA NUMBER - COTS MEDICAL GROUP CORP

Laboratory Demographics

CLIA Number: 10D2278638

Facility Name: COTS MEDICAL GROUP CORP

Facility Address:
26381 S TAMIAMI TRAIL STE 128
BONITA SPRINGS, FL
ZIP 34134
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Facility Phone Number: 786 558-9009

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1245817725

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2278638
LAB Type	Federally Qualified Health Center
Facility Name	COTS MEDICAL GROUP CORP
Street	26381 S TAMIAMI TRAIL STE 128
City	BONITA SPRINGS
State	FL
ZIP	34134
Phone	786 558-9009
CertificateType	4
CertificateEffectiveDate	3/21/2023
CertificateExpirationDate	3/20/2025
FacilityType	Waiver

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