10D2281835 CLIA NUMBER - MAITLAND SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 10D2281835

Facility Name: MAITLAND SURGERY CENTER LLC

Facility Address:
1101 N MAITLAND AVE
MAITLAND, FL
ZIP 32751
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Facility Phone Number: 407 830-6868

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1023075181

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	10D2281835
LAB Type	Ambulatory Surgery Center
Facility Name	MAITLAND SURGERY CENTER LLC
Street	1101 N MAITLAND AVE
City	MAITLAND
State	FL
ZIP	32751
Phone	407 830-6868
CertificateType	4
CertificateEffectiveDate	5/12/2023
CertificateExpirationDate	5/11/2025
FacilityType	Waiver

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