10D2190052 CLIA NUMBER - PINELLAS VASCULAR LLC

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Laboratory Demographics

CLIA Number: 10D2190052

Facility Name: PINELLAS VASCULAR LLC

Facility Address:
5880 49TH ST N, SUITE 206
SAINT PETERSBURG, FL
ZIP 33709
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Facility Phone Number: 727 999-8346

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1285765040

Taxonomy: 207XS0117X - Orthopaedic Surgery
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.

CLIA Record

Field Name	Field Value
CLIA Number	10D2190052
LAB Type	Physician Office
Facility Name	PINELLAS VASCULAR LLC
Street	5880 49TH ST N, SUITE 206
City	SAINT PETERSBURG
State	FL
ZIP	33709
Phone	727 999-8346
CertificateType	4
CertificateEffectiveDate	8/10/2022
CertificateExpirationDate	8/9/2024
FacilityType	Waiver

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