10D1053920 CLIA NUMBER - PHYSICIANS GROUP LLC - DE

Laboratory Demographics

CLIA Number: 10D1053920

Facility Name: PHYSICIANS GROUP LLC - DE

Facility Address:
4754 US HWY 19
NEW PORT RICHEY, FL
ZIP 34652
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Facility Phone Number: 727 842-6471

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275600835

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	10D1053920
LAB Type	Physician Office
Facility Name	PHYSICIANS GROUP LLC - DE
Street	4754 US HWY 19
City	NEW PORT RICHEY
State	FL
ZIP	34652
Phone	727 842-6471
CertificateType	4
CertificateEffectiveDate	5/8/2024
CertificateExpirationDate	5/7/2026
FacilityType	Waiver

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