10D0917407 CLIA NUMBER - KENT R CORRAL MD

Laboratory Demographics

  • CLIA Code: 10D0917407
  • Facility Name: KENT R CORRAL MD
  • Facility Address: 4700 N HABANA AVE - STE 700
    TAMPA, FL
    ZIP 33614
  • Facility Phone: 813 348-0224
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENT R. CORRAL
  • NPI Number: 1295825271
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0917407
LAB Type Physician Office
Facility Name KENT R CORRAL MD
Street 4700 N HABANA AVE - STE 700
City TAMPA
State FL
ZIP 33614
Phone 813 348-0224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director KENT R. CORRAL

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