10D2273599 CLIA NUMBER - MLK RX PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 10D2273599
  • Facility Name: MLK RX PHARMACY LLC
  • Facility Address: 2812 W MARTIN LUTHER KING JR BLVD
    TAMPA, FL
    ZIP 33607
  • Facility Phone: 813 443-4796
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VO H MY
  • NPI Number: 1851038327
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2273599
LAB Type Pharmacy
Facility Name MLK RX PHARMACY LLC
Street 2812 W MARTIN LUTHER KING JR BLVD
City TAMPA
State FL
ZIP 33607
Phone 813 443-4796
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Pharmacy
Lab Director VO H MY

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