10D2220945 CLIA NUMBER - PRECIDENT FLORIDA, PLLC

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Laboratory Demographics

CLIA Number: 10D2220945

Facility Name: PRECIDENT FLORIDA, PLLC

Facility Address:
10601 SEMINOLE BLVD
LARGO, FL
ZIP 33778
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Facility Phone Number: 727 300-0184

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1154045599

Taxonomy: 1223S0112X - Dentist
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

CLIA Record

Field Name	Field Value
CLIA Number	10D2220945
LAB Type	Physician Office
Facility Name	PRECIDENT FLORIDA, PLLC
Street	10601 SEMINOLE BLVD
City	LARGO
State	FL
ZIP	33778
Phone	727 300-0184
CertificateType	4
CertificateEffectiveDate	4/16/2023
CertificateExpirationDate	4/15/2025
FacilityType	Waiver

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