10D2112161 CLIA NUMBER - OHI WEST INC

Laboratory Demographics

CLIA Number: 10D2112161

Facility Name: OHI WEST INC

Facility Address:
7000 4TH ST N
SAINT PETERSBURG, FL
ZIP 33702
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Facility Phone Number: 727 893-6761

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619583184

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2112161
LAB Type	Physician Office
Facility Name	OHI WEST INC
Street	7000 4TH ST N
City	SAINT PETERSBURG
State	FL
ZIP	33702
Phone	727 893-6761
CertificateType	4
CertificateEffectiveDate	4/25/2022
CertificateExpirationDate	4/24/2024
FacilityType	Waiver

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