10D1100079 CLIA NUMBER - FLORIDA SPINE CENTER

Laboratory Demographics

CLIA Number: 10D1100079

Facility Name: FLORIDA SPINE CENTER

Facility Address:
2030 DREW STREET
CLEARWATER, FL
ZIP 33765
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Facility Phone Number: 727 462-5582

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1841315983

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	10D1100079
LAB Type	Physician Office
Facility Name	FLORIDA SPINE CENTER
Street	2030 DREW STREET
City	CLEARWATER
State	FL
ZIP	33765
Phone	727 462-5582
CertificateType	4
CertificateEffectiveDate	5/29/2023
CertificateExpirationDate	5/28/2025
FacilityType	Waiver

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