10D2210928 CLIA NUMBER - LAKE ENDOCRINOLOGY AND DIABETES PLLC

Laboratory Demographics

CLIA Number: 10D2210928

Facility Name: LAKE ENDOCRINOLOGY AND DIABETES PLLC

Facility Address:
13123 66TH STREET
LARGO, FL
ZIP 33773
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Facility Phone Number: 727 477-1039

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619418563

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

CLIA Record

Field Name	Field Value
CLIA Number	10D2210928
LAB Type	Physician Office
Facility Name	LAKE ENDOCRINOLOGY AND DIABETES PLLC
Street	13123 66TH STREET
City	LARGO
State	FL
ZIP	33773
Phone	727 477-1039
CertificateType	4
CertificateEffectiveDate	1/25/2023
CertificateExpirationDate	1/24/2025
FacilityType	Waiver

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