10D0985674 CLIA NUMBER - FLORIDA MEDICAL ASSOCIATES, LLC DBA VIPCARE

Laboratory Demographics

CLIA Number: 10D0985674

Facility Name: FLORIDA MEDICAL ASSOCIATES, LLC DBA VIPCARE

Facility Address:
102 PARK PLACE BLVD
DAVENPORT, FL
ZIP 33837
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Facility Phone Number: 863 422-0032

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1497974133

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	10D0985674
LAB Type	Physician Office
Facility Name	FLORIDA MEDICAL ASSOCIATES, LLC DBA VIPCARE
Street	102 PARK PLACE BLVD
City	DAVENPORT
State	FL
ZIP	33837
Phone	863 422-0032
CertificateType	4
CertificateEffectiveDate	4/25/2023
CertificateExpirationDate	4/24/2025
FacilityType	Waiver

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