10D1104167 CLIA NUMBER - FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE LLC

Laboratory Demographics

CLIA Number: 10D1104167

Facility Name: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE LLC

Facility Address:
3000 MEDICAL PARK DR STE 250
TAMPA, FL
ZIP 33613
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Facility Phone Number: 813 632-6220

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1073841532

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	10D1104167
LAB Type	Physician Office
Facility Name	FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE LLC
Street	3000 MEDICAL PARK DR STE 250
City	TAMPA
State	FL
ZIP	33613
Phone	813 632-6220
CertificateType	1
CertificateEffectiveDate	1/27/2024
CertificateExpirationDate	1/26/2026
FacilityType	Accreditation

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