10D2077664 CLIA NUMBER - BIOSPINE LLC

Laboratory Demographics

  • CLIA Code: 10D2077664
  • Facility Name: BIOSPINE LLC
  • Facility Address: 5301 AVION PARK DR
    TAMPA, FL
    ZIP 33607
  • Facility Phone: 855 485-3262
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MOHAMED SHAHOUT
  • NPI Number: 1154747566
  • Taxonomy: 261QA1903X - Clinic/Center

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Ambulatory Surgery Center
Lab Director MOHAMED SHAHOUT

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This page was last updated on: 9/29/2025