10D2149814 CLIA NUMBER - SUN COAST BARIATRICS

Laboratory Demographics

CLIA Number: 10D2149814

Facility Name: SUN COAST BARIATRICS

Facility Address:
1609 PASADENA AVE - STE 3M
SOUTH PASADENA, FL
ZIP 33707
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Facility Phone Number: 727 771-1285

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619528932

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	10D2149814
LAB Type	Physician Office
Facility Name	SUN COAST BARIATRICS
Street	1609 PASADENA AVE - STE 3M
City	SOUTH PASADENA
State	FL
ZIP	33707
Phone	727 771-1285
CertificateType	4
CertificateEffectiveDate	6/12/2022
CertificateExpirationDate	6/11/2024
FacilityType	Waiver

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