10D2286234 CLIA NUMBER - WEST FLORIDA CARDIOLOGY NETWORK, LLC

Laboratory Demographics

CLIA Number: 10D2286234

Facility Name: WEST FLORIDA CARDIOLOGY NETWORK, LLC

Facility Address:
615 VONDERBURG DR
BRANDON, FL
ZIP 33511
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Facility Phone Number: 813 571-9988

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619642618

Taxonomy: 2086S0129X - Surgery
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

CLIA Record

Field Name Field Value
CLIA Number 10D2286234
LAB Type Physician Office
Facility Name WEST FLORIDA CARDIOLOGY NETWORK, LLC
Street 615 VONDERBURG DR
City BRANDON
State FL
ZIP 33511
Phone 813 571-9988
CertificateType 4
CertificateEffectiveDate 7/26/2023
CertificateExpirationDate 7/25/2025
FacilityType Waiver

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