10D2153403 CLIA NUMBER - PHYSICAL CHIROPRACTIC OF TAMPA BAY

Laboratory Demographics

CLIA Number: 10D2153403

Facility Name: PHYSICAL CHIROPRACTIC OF TAMPA BAY

Facility Address:
5810 W CYPRESS ST #D
TAMPA, FL
ZIP 33607
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Facility Phone Number: 813 207-5027

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1689819732

Taxonomy: 261QR0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2153403
LAB Type	Physician Office
Facility Name	PHYSICAL CHIROPRACTIC OF TAMPA BAY
Street	5810 W CYPRESS ST #D
City	TAMPA
State	FL
ZIP	33607
Phone	813 207-5027
CertificateType	4
CertificateEffectiveDate	8/24/2022
CertificateExpirationDate	8/23/2024
FacilityType	Waiver

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