10D2152309 CLIA NUMBER - TAMPA BAY DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 10D2152309
  • Facility Name: TAMPA BAY DERMATOLOGY LLC
  • Facility Address: 2727 W DR MARTIN LUTHER KING JR DR STE 570
    TAMPA, FL
    ZIP 33607
  • Facility Phone: 813 867-6200
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JONATHAN LOPEZ
  • NPI Number: 1528371069
  • Taxonomy: 2085R0001X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2152309
LAB Type Physician Office
Facility Name TAMPA BAY DERMATOLOGY LLC
Street 2727 W DR MARTIN LUTHER KING JR DR STE 570
City TAMPA
State FL
ZIP 33607
Phone 813 867-6200
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Physician Office
Lab Director JONATHAN LOPEZ

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