10D0722643 CLIA NUMBER - HEART OF FLORIDA HEALTH CENTER INC

Laboratory Demographics

CLIA Number: 10D0722643

Facility Name: HEART OF FLORIDA HEALTH CENTER INC

Facility Address:
5051 SE 110TH ST
BELLEVIEW, FL
ZIP 34420
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Facility Phone Number: 352 732-6599

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1174192843

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	10D0722643
LAB Type	Federally Qualified Health Center
Facility Name	HEART OF FLORIDA HEALTH CENTER INC
Street	5051 SE 110TH ST
City	BELLEVIEW
State	FL
ZIP	34420
Phone	352 732-6599
CertificateType	4
CertificateEffectiveDate	7/2/2022
CertificateExpirationDate	7/1/2024
FacilityType	Waiver

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