10D2300690 CLIA NUMBER - PRIME SURGERY CENTER CORPORATION

Laboratory Demographics

  • CLIA Code: 10D2300690
  • Facility Name: PRIME SURGERY CENTER CORPORATION
  • Facility Address: 63 BARKLEY CIRCLE #101
    FORT MYERS, FL
    ZIP 33919
  • Facility Phone: 954 552-8476
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FREDERICK E. HASTY
  • NPI Number: 1700778487
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2300690
LAB Type Physician Office
Facility Name PRIME SURGERY CENTER CORPORATION
Street 63 BARKLEY CIRCLE #101
City FORT MYERS
State FL
ZIP 33919
Phone 954 552-8476
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Physician Office
Lab Director FREDERICK E. HASTY

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