10D2144788 CLIA NUMBER - MANATEE GYNECOLOGY LLC

Laboratory Demographics

CLIA Number: 10D2144788

Facility Name: MANATEE GYNECOLOGY LLC

Facility Address:
2310 60TH ST CT WEST
BRADENTON, FL
ZIP 34209
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Facility Phone Number: 941 792-4993

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1578077970

Taxonomy: 207VG0400X - Obstetrics & Gynecology
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	10D2144788
LAB Type	Physician Office
Facility Name	MANATEE GYNECOLOGY LLC
Street	2310 60TH ST CT WEST
City	BRADENTON
State	FL
ZIP	34209
Phone	941 792-4993
CertificateType	3
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	PPMP

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