10D0923343 CLIA NUMBER - BMA OF YBOR CITY

Laboratory Demographics

CLIA Number: 10D0923343

Facility Name: BMA OF YBOR CITY

Facility Address:
2525 E HILLSBOROUGH AVE STE 209
TAMPA, FL
ZIP 33610
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Facility Phone Number: 813 247-5720

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1891807657

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0923343
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	BMA OF YBOR CITY
Street	2525 E HILLSBOROUGH AVE STE 209
City	TAMPA
State	FL
ZIP	33610
Phone	813 247-5720
CertificateType	4
CertificateEffectiveDate	1/6/2023
CertificateExpirationDate	1/5/2025
FacilityType	Waiver

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