10D2004320 CLIA NUMBER - YOUR PLACE MEDICAL AND FITNESS CTR

Laboratory Demographics

  • CLIA Code: 10D2004320
  • Facility Name: YOUR PLACE MEDICAL AND FITNESS CTR
  • Facility Address: 3801 34TH ST, S
    SAINT PETERSBURG, FL
    ZIP 33711
  • Facility Phone: 813 579-4013
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SYDEL LEGRANDE
  • NPI Number: 1801129119
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2004320
LAB Type Physician Office
Facility Name YOUR PLACE MEDICAL AND FITNESS CTR
Street 3801 34TH ST, S
City SAINT PETERSBURG
State FL
ZIP 33711
Phone 813 579-4013
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2024
Certificate Expiration Date 3/2/2026
Facility Type Physician Office
Lab Director SYDEL LEGRANDE

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