10D2168557 CLIA NUMBER - TAMARA LOPEZ-DIAZ MD PA

Laboratory Demographics

CLIA Number: 10D2168557

Facility Name: TAMARA LOPEZ-DIAZ MD PA

Facility Address:
12301 SE US HWY 441 STE C
BELLEVIEW, FL
ZIP 34420
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Facility Phone Number: 352 327-8106

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124579974

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2168557
LAB Type	Physician Office
Facility Name	TAMARA LOPEZ-DIAZ MD PA
Street	12301 SE US HWY 441 STE C
City	BELLEVIEW
State	FL
ZIP	34420
Phone	352 327-8106
CertificateType	4
CertificateEffectiveDate	7/2/2023
CertificateExpirationDate	7/1/2025
FacilityType	Waiver

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