10D2023459 CLIA NUMBER - EVENING PEDIATRICS INC

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Laboratory Demographics

CLIA Number: 10D2023459

Facility Name: EVENING PEDIATRICS INC

Facility Address:
12190 SEMINOLE BLVD
LARGO, FL
ZIP 33778
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Facility Phone Number: 727 526-9135

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275109480

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2023459
LAB Type	Physician Office
Facility Name	EVENING PEDIATRICS INC
Street	12190 SEMINOLE BLVD
City	LARGO
State	FL
ZIP	33778
Phone	727 526-9135
CertificateType	4
CertificateEffectiveDate	4/28/2023
CertificateExpirationDate	4/27/2025
FacilityType	Waiver

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