10D2107533 CLIA NUMBER - PANIRA HEALTHCARE CLINIC

Laboratory Demographics

CLIA Number: 10D2107533

Facility Name: PANIRA HEALTHCARE CLINIC

Facility Address:
4975 E TAMIAMI TRAIL
NAPLES, FL
ZIP 34113
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Facility Phone Number: 239 529-5580

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1619341369

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2107533
LAB Type	Community Clinic
Facility Name	PANIRA HEALTHCARE CLINIC
Street	4975 E TAMIAMI TRAIL
City	NAPLES
State	FL
ZIP	34113
Phone	239 529-5580
CertificateType	4
CertificateEffectiveDate	1/15/2024
CertificateExpirationDate	1/14/2026
FacilityType	Waiver

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