10D2210110 CLIA NUMBER - ADVANCED MOBILE MEDICAL SERVICES

Laboratory Demographics

CLIA Number: 10D2210110

Facility Name: ADVANCED MOBILE MEDICAL SERVICES

Facility Address:
5118 N 56TH ST - STE 100
TAMPA, FL
ZIP 33610
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Facility Phone Number: 813 710-9555

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1912528290

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2210110
LAB Type	Practitioner Other
Facility Name	ADVANCED MOBILE MEDICAL SERVICES
Street	5118 N 56TH ST - STE 100
City	TAMPA
State	FL
ZIP	33610
Phone	813 710-9555
CertificateType	4
CertificateEffectiveDate	1/20/2023
CertificateExpirationDate	1/19/2025
FacilityType	Waiver

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