10D1105007 CLIA NUMBER - BROOKSHIRE RHEUMATOLOGY & WELLNESS CTR

Laboratory Demographics

CLIA Number: 10D1105007

Facility Name: BROOKSHIRE RHEUMATOLOGY & WELLNESS CTR

Facility Address:
16594 N DALE MABRY HWY
TAMPA, FL
ZIP 33618
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Facility Phone Number: 813 933-1944

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1730633314

Taxonomy: 207RR0500X - Internal Medicine
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

CLIA Record

Field Name	Field Value
CLIA Number	10D1105007
LAB Type	Physician Office
Facility Name	BROOKSHIRE RHEUMATOLOGY & WELLNESS CTR
Street	16594 N DALE MABRY HWY
City	TAMPA
State	FL
ZIP	33618
Phone	813 933-1944
CertificateType	4
CertificateEffectiveDate	9/15/2023
CertificateExpirationDate	9/14/2025
FacilityType	Waiver

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