10D2136074 CLIA NUMBER - CARILLON SPORTS AND FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 10D2136074

Facility Name: CARILLON SPORTS AND FAMILY MEDICINE

Facility Address:
12225 28TH ST, N STE B
SAINT PETERSBURG, FL
ZIP 33716
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Facility Phone Number: 727 561-4303

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275730970

Taxonomy: 207QS0010X - Family Medicine
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

CLIA Record

Field Name	Field Value
CLIA Number	10D2136074
LAB Type	Physician Office
Facility Name	CARILLON SPORTS AND FAMILY MEDICINE
Street	12225 28TH ST, N STE B
City	SAINT PETERSBURG
State	FL
ZIP	33716
Phone	727 561-4303
CertificateType	4
CertificateEffectiveDate	9/1/2023
CertificateExpirationDate	8/31/2025
FacilityType	Waiver

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