10D0290189 CLIA NUMBER - FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE LLC

Laboratory Demographics

CLIA Number: 10D0290189

Facility Name: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE LLC

Facility Address:
3402 W DR MARTIN LUTHER KING JR BLVD
TAMPA, FL
ZIP 33607
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Facility Phone Number: 813 875-3950

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1104071349

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	10D0290189
LAB Type	Physician Office
Facility Name	FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE LLC
Street	3402 W DR MARTIN LUTHER KING JR BLVD
City	TAMPA
State	FL
ZIP	33607
Phone	813 875-3950
CertificateType	1
CertificateEffectiveDate	9/4/2023
CertificateExpirationDate	9/3/2025
FacilityType	Accreditation

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