10D0295177 CLIA NUMBER - WESTSIDE MEDICAL CARE

Laboratory Demographics

CLIA Number: 10D0295177

Facility Name: WESTSIDE MEDICAL CARE

Facility Address:
2225 59TH ST W SUITE B
BRADENTON, FL
ZIP 34209
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Facility Phone Number: 941 792-1412

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1730239583

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	10D0295177
LAB Type	Physician Office
Facility Name	WESTSIDE MEDICAL CARE
Street	2225 59TH ST W SUITE B
City	BRADENTON
State	FL
ZIP	34209
Phone	941 792-1412
CertificateType	4
CertificateEffectiveDate	4/19/2024
CertificateExpirationDate	4/18/2026
FacilityType	Waiver

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