10D2060166 CLIA NUMBER - TRICOUNTY PHYSICIANS LLC

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Laboratory Demographics

CLIA Number: 10D2060166

Facility Name: TRICOUNTY PHYSICIANS LLC

Facility Address:
1507 BUENOS AIRES BLVD
THE VILLAGES, FL
ZIP 32159
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Facility Phone Number: 352 561-6299

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1619507431

Taxonomy: -

CLIA Record

Field Name	Field Value
CLIA Number	10D2060166
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	TRICOUNTY PHYSICIANS LLC
Street	1507 BUENOS AIRES BLVD
City	THE VILLAGES
State	FL
ZIP	32159
Phone	352 561-6299
CertificateType	4
CertificateEffectiveDate	6/7/2023
CertificateExpirationDate	6/6/2025
FacilityType	Waiver

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