10D2085285 CLIA NUMBER - NEW TAMPA INTERNAL MEDICINE

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Laboratory Demographics

CLIA Number: 10D2085285

Facility Name: NEW TAMPA INTERNAL MEDICINE

Facility Address:
14486 UNIVERSITY COVE PL
TAMPA, FL
ZIP 33613
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Facility Phone Number: 813 252-2770

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1154411940

Taxonomy: 261QM1200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2085285
LAB Type	Physician Office
Facility Name	NEW TAMPA INTERNAL MEDICINE
Street	14486 UNIVERSITY COVE PL
City	TAMPA
State	FL
ZIP	33613
Phone	813 252-2770
CertificateType	4
CertificateEffectiveDate	10/10/2022
CertificateExpirationDate	10/9/2024
FacilityType	Waiver

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