10D2217072 CLIA NUMBER - TCL MEDICAL INC

Laboratory Demographics

CLIA Number: 10D2217072

Facility Name: TCL MEDICAL INC

Facility Address:
6613 49TH ST N
PINELLAS PARK, FL
ZIP 33781
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Facility Phone Number: 727 490-8670

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1093398802

Taxonomy: 363LP0808X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2217072
LAB Type	Practitioner Other
Facility Name	TCL MEDICAL INC
Street	6613 49TH ST N
City	PINELLAS PARK
State	FL
ZIP	33781
Phone	727 490-8670
CertificateType	4
CertificateEffectiveDate	3/18/2023
CertificateExpirationDate	3/17/2025
FacilityType	Waiver

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