10D2201409 CLIA NUMBER - MAR PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 10D2201409
  • Facility Name: MAR PRIMARY CARE LLC
  • Facility Address: 2901 W SAINT ISABEL ST SUITE F
    TAMPA, FL
    ZIP 33607
  • Facility Phone: 813 935-4744
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NELSON MANE
  • NPI Number: 1417423344
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2201409
LAB Type Physician Office
Facility Name MAR PRIMARY CARE LLC
Street 2901 W SAINT ISABEL ST SUITE F
City TAMPA
State FL
ZIP 33607
Phone 813 935-4744
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2024
Certificate Expiration Date 11/19/2026
Facility Type Physician Office
Lab Director NELSON MANE

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