10D2090728 CLIA NUMBER - GULFCOAST EYE CARE

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Laboratory Demographics

CLIA Number: 10D2090728

Facility Name: GULFCOAST EYE CARE

Facility Address:
6036 PARK BLVD
PINELLAS PARK, FL
ZIP 33781
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Facility Phone Number: 727 785-4419

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1922297977

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	10D2090728
LAB Type	Physician Office
Facility Name	GULFCOAST EYE CARE
Street	6036 PARK BLVD
City	PINELLAS PARK
State	FL
ZIP	33781
Phone	727 785-4419
CertificateType	4
CertificateEffectiveDate	1/29/2023
CertificateExpirationDate	1/28/2025
FacilityType	Waiver

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