10D2260903 CLIA NUMBER - AMA MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 10D2260903
  • Facility Name: AMA MEDICAL GROUP
  • Facility Address: 1280 MISSOURI AVENUE
    LARGO, FL
    ZIP 33770
  • Facility Phone: 727 331-8740
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CRUZ FANA-SOUCHET
  • NPI Number: 1174834717
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2260903
LAB Type Physician Office
Facility Name AMA MEDICAL GROUP
Street 1280 MISSOURI AVENUE
City LARGO
State FL
ZIP 33770
Phone 727 331-8740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Physician Office
Lab Director CRUZ FANA-SOUCHET

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This page was last updated on: 9/29/2025