10D1092729 CLIA NUMBER - WESLEY CHAPEL MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 10D1092729

Facility Name: WESLEY CHAPEL MEDICAL CLINIC

Facility Address:
5819 ARGERIAN DR
WESLEY CHAPEL, FL
ZIP 33543
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Facility Phone Number: 813 994-0800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184760290

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D1092729
LAB Type	Physician Office
Facility Name	WESLEY CHAPEL MEDICAL CLINIC
Street	5819 ARGERIAN DR
City	WESLEY CHAPEL
State	FL
ZIP	33543
Phone	813 994-0800
CertificateType	4
CertificateEffectiveDate	8/9/2022
CertificateExpirationDate	8/8/2024
FacilityType	Waiver

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