10D2098897 CLIA NUMBER - DIAZ MEDICAL CENTER INC

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Laboratory Demographics

CLIA Number: 10D2098897

Facility Name: DIAZ MEDICAL CENTER INC

Facility Address:
303 BRYAN RD STE 1
BRANDON, FL
ZIP 33511
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Facility Phone Number: 813 684-6867

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053795815

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2098897
LAB Type	Physician Office
Facility Name	DIAZ MEDICAL CENTER INC
Street	303 BRYAN RD STE 1
City	BRANDON
State	FL
ZIP	33511
Phone	813 684-6867
CertificateType	4
CertificateEffectiveDate	7/16/2023
CertificateExpirationDate	7/15/2025
FacilityType	Waiver

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