10D2293292 CLIA NUMBER - BLUE WAVE MEDICAL ASSOCIATES LLC

Laboratory Demographics

CLIA Number: 10D2293292

Facility Name: BLUE WAVE MEDICAL ASSOCIATES LLC

Facility Address:
1822 DREW ST
CLEARWATER, FL
ZIP 33765
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Facility Phone Number: 727 303-3117

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1760167233

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	10D2293292
LAB Type	Physician Office
Facility Name	BLUE WAVE MEDICAL ASSOCIATES LLC
Street	1822 DREW ST
City	CLEARWATER
State	FL
ZIP	33765
Phone	727 303-3117
CertificateType	4
CertificateEffectiveDate	11/7/2023
CertificateExpirationDate	11/6/2025
FacilityType	Waiver

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