10D2160307 CLIA NUMBER - NURSE PRACTITIONERS OF PINELLAS LLC

Laboratory Demographics

CLIA Number: 10D2160307

Facility Name: NURSE PRACTITIONERS OF PINELLAS LLC

Facility Address:
4611 34TH STREET S
SAINT PETERSBURG, FL
ZIP 33711
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Facility Phone Number: 727 290-6116

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1851878094

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2160307
LAB Type	Practitioner Other
Facility Name	NURSE PRACTITIONERS OF PINELLAS LLC
Street	4611 34TH STREET S
City	SAINT PETERSBURG
State	FL
ZIP	33711
Phone	727 290-6116
CertificateType	4
CertificateEffectiveDate	1/8/2023
CertificateExpirationDate	1/7/2025
FacilityType	Waiver

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