10D2210595 CLIA NUMBER - JI UNIVERSAL MEDICAL GROUP LLC

Laboratory Demographics

CLIA Number: 10D2210595

Facility Name: JI UNIVERSAL MEDICAL GROUP LLC

Facility Address:
8903 REGENTS PARK DR - STE 120
TAMPA, FL
ZIP 33647
Get Directions

Facility Phone Number: 813 577-2622

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1811518111

Taxonomy: 363L00000X - Nurse Practitioner
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

CLIA Record

Field Name	Field Value
CLIA Number	10D2210595
LAB Type	Practitioner Other
Facility Name	JI UNIVERSAL MEDICAL GROUP LLC
Street	8903 REGENTS PARK DR - STE 120
City	TAMPA
State	FL
ZIP	33647
Phone	813 577-2622
CertificateType	4
CertificateEffectiveDate	1/22/2023
CertificateExpirationDate	1/21/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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