10D2262074 CLIA NUMBER - PURPOSELY EVOLVING

Laboratory Demographics

  • CLIA Code: 10D2262074
  • Facility Name: PURPOSELY EVOLVING
  • Facility Address: 1810 S PINELLAS AVE SUITE B
    TARPON SPRINGS, FL
    ZIP 34689
  • Facility Phone: 727 937-6060
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DOMINIQUE S. PASCHAL
  • NPI Number: 1609582782
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2262074
LAB Type Practitioner Other
Facility Name PURPOSELY EVOLVING
Street 1810 S PINELLAS AVE SUITE B
City TARPON SPRINGS
State FL
ZIP 34689
Phone 727 937-6060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Practitioner Other
Lab Director DOMINIQUE S. PASCHAL

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