10D0858344 CLIA NUMBER - OPTUMCARE FLORIDA LLC

Laboratory Demographics

CLIA Number: 10D0858344

Facility Name: OPTUMCARE FLORIDA LLC

Facility Address:
7501 DR MLK JR ST N
SAINT PETERSBURG, FL
ZIP 33702
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Facility Phone Number: 727 527-6719

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1922492883

Taxonomy: 332900000X - Non-Pharmacy Dispensing Site
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

CLIA Record

Field Name	Field Value
CLIA Number	10D0858344
LAB Type	Physician Office
Facility Name	OPTUMCARE FLORIDA LLC
Street	7501 DR MLK JR ST N
City	SAINT PETERSBURG
State	FL
ZIP	33702
Phone	727 527-6719
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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