10D2130985 CLIA NUMBER - CHILDRENS DOCTOR OF TAMPA BAY, THE

Laboratory Demographics

  • CLIA Code: 10D2130985
  • Facility Name: CHILDRENS DOCTOR OF TAMPA BAY, THE
  • Facility Address: 14499 N DALE MABRY HWY STE 180-S
    TAMPA, FL
    ZIP 33618
  • Facility Phone: 813 501-3710
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE NIEBLES
  • NPI Number: 1578628525
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2130985
LAB Type Physician Office
Facility Name CHILDRENS DOCTOR OF TAMPA BAY, THE
Street 14499 N DALE MABRY HWY STE 180-S
City TAMPA
State FL
ZIP 33618
Phone 813 501-3710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Physician Office
Lab Director JACQUELINE NIEBLES

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025