10D1090798 CLIA NUMBER - GREATER TAMPA AT HOME

Laboratory Demographics

  • CLIA Code: 10D1090798
  • Facility Name: GREATER TAMPA AT HOME
  • Facility Address: 4204 N MACDILL AVE STE B
    TAMPA, FL
    ZIP 33607
  • Facility Phone: 813 872-8216
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JAYESH SHAH
  • NPI Number: 1205006228
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1090798
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name GREATER TAMPA AT HOME
Street 4204 N MACDILL AVE STE B
City TAMPA
State FL
ZIP 33607
Phone 813 872-8216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JAYESH SHAH

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