10D2206352 CLIA NUMBER - TAMPA BREEZE DIALYSIS

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Laboratory Demographics

CLIA Number: 10D2206352

Facility Name: TAMPA BREEZE DIALYSIS

Facility Address:
6914 SHELDON DR - STE 102
TAMPA, FL
ZIP 33615
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Facility Phone Number: 863 663-3071

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1457957870

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2206352
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	TAMPA BREEZE DIALYSIS
Street	6914 SHELDON DR - STE 102
City	TAMPA
State	FL
ZIP	33615
Phone	863 663-3071
CertificateType	4
CertificateEffectiveDate	12/18/2022
CertificateExpirationDate	12/17/2024
FacilityType	Waiver

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