10D2289974 CLIA NUMBER - AZIMUTH HEALTH, LLC

Laboratory Demographics

CLIA Number: 10D2289974

Facility Name: AZIMUTH HEALTH, LLC

Facility Address:
4204 W LINEBAUGH AVE
TAMPA, FL
ZIP 33624
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Facility Phone Number: 813 940-8855

Facility Type: Health Fair

Certificate Type: Waiver

NPI Number: 1306450085

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2289974
LAB Type	Health Fair
Facility Name	AZIMUTH HEALTH, LLC
Street	4204 W LINEBAUGH AVE
City	TAMPA
State	FL
ZIP	33624
Phone	813 940-8855
CertificateType	4
CertificateEffectiveDate	9/19/2023
CertificateExpirationDate	9/18/2025
FacilityType	Waiver

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