10D2079128 CLIA NUMBER - WOMENS CARE FLORIDA

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Laboratory Demographics

CLIA Number: 10D2079128

Facility Name: WOMENS CARE FLORIDA

Facility Address:
4213 GOMEZ AVE
TAMPA, FL
ZIP 33607
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Facility Phone Number: 813 286-0033

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1922310515

Taxonomy: 363LX0001X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2079128
LAB Type	Physician Office
Facility Name	WOMENS CARE FLORIDA
Street	4213 GOMEZ AVE
City	TAMPA
State	FL
ZIP	33607
Phone	813 286-0033
CertificateType	4
CertificateEffectiveDate	6/11/2022
CertificateExpirationDate	6/10/2024
FacilityType	Waiver

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