10D2077664 CLIA NUMBER - BIOSPINE LLC

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Laboratory Demographics

CLIA Number: 10D2077664

Facility Name: BIOSPINE LLC

Facility Address:
5301 AVION PARK DR
TAMPA, FL
ZIP 33607
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Facility Phone Number: 855 485-3262

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1154747566

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2077664
LAB Type	Ambulatory Surgery Center
Facility Name	BIOSPINE LLC
Street	5301 AVION PARK DR
City	TAMPA
State	FL
ZIP	33607
Phone	855 485-3262
CertificateType	4
CertificateEffectiveDate	5/13/2022
CertificateExpirationDate	5/12/2024
FacilityType	Waiver

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