10D2110420 CLIA NUMBER - MEDI CLINICS PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 10D2110420
  • Facility Name: MEDI CLINICS PRIMARY CARE LLC
  • Facility Address: 502 S MACDILL AVE
    TAMPA, FL
    ZIP 33609
  • Facility Phone: 813 877-5111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VENKATA J. BIREDDY
  • NPI Number: 1609120534
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2110420
LAB Type Physician Office
Facility Name MEDI CLINICS PRIMARY CARE LLC
Street 502 S MACDILL AVE
City TAMPA
State FL
ZIP 33609
Phone 813 877-5111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Physician Office
Lab Director VENKATA J. BIREDDY

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This page was last updated on: 3/20/2025