10D2079513 CLIA NUMBER - FLORIDA UROLOGY PARTNERS LLP

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Laboratory Demographics

CLIA Number: 10D2079513

Facility Name: FLORIDA UROLOGY PARTNERS LLP

Facility Address:
1142 BELL SHOALS RD
BRANDON, FL
ZIP 33511
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Facility Phone Number: 813 685-0827

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558811315

Taxonomy: 332900000X - Non-Pharmacy Dispensing Site
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

CLIA Record

Field Name	Field Value
CLIA Number	10D2079513
LAB Type	Physician Office
Facility Name	FLORIDA UROLOGY PARTNERS LLP
Street	1142 BELL SHOALS RD
City	BRANDON
State	FL
ZIP	33511
Phone	813 685-0827
CertificateType	4
CertificateEffectiveDate	6/17/2022
CertificateExpirationDate	6/16/2024
FacilityType	Waiver

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