10D2000247 CLIA NUMBER - GULF COAST INTERNIST LLC

Laboratory Demographics

  • CLIA Code: 10D2000247
  • Facility Name: GULF COAST INTERNIST LLC
  • Facility Address: 4957 38TH AVE N STE C
    SAINT PETERSBURG, FL
    ZIP 33710
  • Facility Phone: 727 525-0900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAVITA B. RAO
  • NPI Number: 1114155355
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2000247
LAB Type Physician Office
Facility Name GULF COAST INTERNIST LLC
Street 4957 38TH AVE N STE C
City SAINT PETERSBURG
State FL
ZIP 33710
Phone 727 525-0900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2023
Certificate Expiration Date 11/23/2025
Facility Type Physician Office
Lab Director KAVITA B. RAO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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