10D2261012 CLIA NUMBER - MENTAL HEALTH CARE, INC DBA GRACEPOINT HEALTH CENTERS N TAMPA

Laboratory Demographics

CLIA Number: 10D2261012

Facility Name: MENTAL HEALTH CARE, INC DBA GRACEPOINT HEALTH CENTERS N TAMPA

Facility Address:
13601 BRUCE B DOWNS BLVD - STE 131
TAMPA, FL
ZIP 33610
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Facility Phone Number: 813 224-2272

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1124315296

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2261012
LAB Type	Federally Qualified Health Center
Facility Name	MENTAL HEALTH CARE, INC DBA GRACEPOINT HEALTH CENTERS N TAMPA
Street	13601 BRUCE B DOWNS BLVD - STE 131
City	TAMPA
State	FL
ZIP	33610
Phone	813 224-2272
CertificateType	4
CertificateEffectiveDate	5/25/2022
CertificateExpirationDate	5/24/2024
FacilityType	Waiver

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