10D0956150 CLIA NUMBER - MARK A NOWACKI MD PA

Laboratory Demographics

  • CLIA Code: 10D0956150
  • Facility Name: MARK A NOWACKI MD PA
  • Facility Address: 7011 1ST AVENUE SOUTH
    SAINT PETERSBURG, FL
    ZIP 33707
  • Facility Phone: (727) 347-4158
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK A. NOWACKI
  • NPI Number: 1427440213
  • Taxonomy: 305R00000X - Preferred Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 10D0956150
LAB Type Physician Office
Facility Name MARK A NOWACKI MD PA
Street 7011 1ST AVENUE SOUTH
City SAINT PETERSBURG
State FL
ZIP 33707
Phone 7273474158
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2025
Certificate Expiration Date 1/20/2027
Facility Type Physician Office
Lab Director MARK A. NOWACKI

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This page was last updated on: 5/18/2026