10D1074366 CLIA NUMBER - TRINITY PACIFIC 5 LLC DBA PROVIDENCE HOME CARE OF FLORIDA

Laboratory Demographics

  • CLIA Code: 10D1074366
  • Facility Name: TRINITY PACIFIC 5 LLC DBA PROVIDENCE HOME CARE OF FLORIDA
  • Facility Address: 28051 US HWY 19 N STE 107
    CLEARWATER, FL
    ZIP 33761
  • Facility Phone: 727 295-9711
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: KRISTI L. BROWN
  • NPI Number: 1356686166
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 10D1074366
LAB Type Home Health Agency
Facility Name TRINITY PACIFIC 5 LLC DBA PROVIDENCE HOME CARE OF FLORIDA
Street 28051 US HWY 19 N STE 107
City CLEARWATER
State FL
ZIP 33761
Phone 727 295-9711
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2025
Certificate Expiration Date 3/15/2027
Facility Type Home Health Agency
Lab Director KRISTI L. BROWN

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