10D2283608 CLIA NUMBER - ADVANCED WOUND, OSTOMY AND CONTINENCE CARE, LLC

Laboratory Demographics

CLIA Number: 10D2283608

Facility Name: ADVANCED WOUND, OSTOMY AND CONTINENCE CARE, LLC

Facility Address:
9401 SW HWY 200 - STE 2004
OCALA, FL
ZIP 34481
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Facility Phone Number: 352 897-0063

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1699180240

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2283608
LAB Type	Physician Office
Facility Name	ADVANCED WOUND, OSTOMY AND CONTINENCE CARE, LLC
Street	9401 SW HWY 200 - STE 2004
City	OCALA
State	FL
ZIP	34481
Phone	352 897-0063
CertificateType	4
CertificateEffectiveDate	6/9/2023
CertificateExpirationDate	6/8/2025
FacilityType	Waiver

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