10D1083891 CLIA NUMBER - HOLISTIC PEDIATRICS GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D1083891
  • Facility Name: HOLISTIC PEDIATRICS GROUP LLC
  • Facility Address: 2906 W TAMPA BAY BLVD
    TAMPA, FL
    ZIP 33607
  • Facility Phone: 813 879-1985
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AVILIO E. MUNOZ
  • NPI Number: 1437339231
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D1083891
LAB Type Physician Office
Facility Name HOLISTIC PEDIATRICS GROUP LLC
Street 2906 W TAMPA BAY BLVD
City TAMPA
State FL
ZIP 33607
Phone 813 879-1985
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Physician Office
Lab Director AVILIO E. MUNOZ

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