10D2201474 CLIA NUMBER - PATRICK MANOR INCORPORATED

Laboratory Demographics

  • CLIA Code: 10D2201474
  • Facility Name: PATRICK MANOR INCORPORATED
  • Facility Address: 896 73RD AVE N
    SAINT PETERSBURG, FL
    ZIP 33702
  • Facility Phone: 727 521-1843
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: THERESA L. PUTNAM
  • NPI Number: 1578992392
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2201474
LAB Type Assisted Living Facility
Facility Name PATRICK MANOR INCORPORATED
Street 896 73RD AVE N
City SAINT PETERSBURG
State FL
ZIP 33702
Phone 727 521-1843
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 Assisted Living Facility
Lab Director THERESA L. PUTNAM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025