10D1057545 CLIA NUMBER - BAYCARE MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 10D1057545
  • Facility Name: BAYCARE MEDICAL GROUP INC
  • Facility Address: 6801 4TH ST NORTH
    SAINT PETERSBURG, FL
    ZIP 33702
  • Facility Phone: 727 822-3238
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTIAN BENGSTON
  • NPI Number: 1205408317
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1057545
LAB Type Physician Office
Facility Name BAYCARE MEDICAL GROUP INC
Street 6801 4TH ST NORTH
City SAINT PETERSBURG
State FL
ZIP 33702
Phone 727 822-3238
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Physician Office
Lab Director CHRISTIAN BENGSTON

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