10D2263743 CLIA NUMBER - ST PETE NURSE PRACTITIONER, LLC

Laboratory Demographics

  • CLIA Code: 10D2263743
  • Facility Name: ST PETE NURSE PRACTITIONER, LLC
  • Facility Address: 33 4TH ST N SUITE 202
    SAINT PETERSBURG, FL
    ZIP 33701
  • Facility Phone: 727 686-8284
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSICA CARABALLO
  • NPI Number: 1720724297
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2263743
LAB Type Physician Office
Facility Name ST PETE NURSE PRACTITIONER, LLC
Street 33 4TH ST N SUITE 202
City SAINT PETERSBURG
State FL
ZIP 33701
Phone 727 686-8284
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2024
Certificate Expiration Date 7/4/2026
Facility Type Physician Office
Lab Director JESSICA CARABALLO

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