10D2052904 CLIA NUMBER - BAYCARE MEDICAL GROUP INC

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Laboratory Demographics

CLIA Number: 10D2052904

Facility Name: BAYCARE MEDICAL GROUP INC

Facility Address:
646 VIRGINIA ST STE 200
DUNEDIN, FL
ZIP 34698
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Facility Phone Number: 727 738-1515

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1043889959

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2052904
LAB Type	Physician Office
Facility Name	BAYCARE MEDICAL GROUP INC
Street	646 VIRGINIA ST STE 200
City	DUNEDIN
State	FL
ZIP	34698
Phone	727 738-1515
CertificateType	4
CertificateEffectiveDate	1/22/2023
CertificateExpirationDate	1/21/2025
FacilityType	Waiver

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