10D2046972 CLIA NUMBER - OPTUMCARE FLORIDA LLC

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Laboratory Demographics

CLIA Number: 10D2046972

Facility Name: OPTUMCARE FLORIDA LLC

Facility Address:
8950 DR MLK JR STREET N STE 180
SAINT PETERSBURG, FL
ZIP 33702
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Facility Phone Number: 727 576-8900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1790845923

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	10D2046972
LAB Type	Physician Office
Facility Name	OPTUMCARE FLORIDA LLC
Street	8950 DR MLK JR STREET N STE 180
City	SAINT PETERSBURG
State	FL
ZIP	33702
Phone	727 576-8900
CertificateType	4
CertificateEffectiveDate	9/14/2022
CertificateExpirationDate	9/13/2024
FacilityType	Waiver

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