10D2227313 CLIA NUMBER - FLORIDA MEDICAL ASSOCIATES LLC DBA VIPCARE

Laboratory Demographics

CLIA Number: 10D2227313

Facility Name: FLORIDA MEDICAL ASSOCIATES LLC DBA VIPCARE

Facility Address:
11794 S US HWY 301
RIVERVIEW, FL
ZIP 33578
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Facility Phone Number: 813 450-4609

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1528738663

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2227313
LAB Type	Physician Office
Facility Name	FLORIDA MEDICAL ASSOCIATES LLC DBA VIPCARE
Street	11794 S US HWY 301
City	RIVERVIEW
State	FL
ZIP	33578
Phone	813 450-4609
CertificateType	4
CertificateEffectiveDate	6/10/2023
CertificateExpirationDate	6/9/2025
FacilityType	Waiver

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