10D1062548 CLIA NUMBER - PARTNERS IMAGING CENTER OF BRADENTON LLC

Laboratory Demographics

CLIA Number: 10D1062548

Facility Name: PARTNERS IMAGING CENTER OF BRADENTON LLC

Facility Address:
5101 4TH AVE CIR E 1
BRADENTON, FL
ZIP 34208
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Facility Phone Number: 941 377-7975

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1033432166

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1062548
LAB Type	Physician Office
Facility Name	PARTNERS IMAGING CENTER OF BRADENTON LLC
Street	5101 4TH AVE CIR E 1
City	BRADENTON
State	FL
ZIP	34208
Phone	941 377-7975
CertificateType	4
CertificateEffectiveDate	12/18/2022
CertificateExpirationDate	12/17/2024
FacilityType	Waiver

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