10D2300179 CLIA NUMBER - WEST COAST NEONATOLOGY INC

Laboratory Demographics

CLIA Number: 10D2300179

Facility Name: WEST COAST NEONATOLOGY INC

Facility Address:
9332 STATE ROAD 54 SUITE 407
TRINITY, FL
ZIP 34655
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Facility Phone Number: 727 767-8988

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1033166889

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	10D2300179
LAB Type	Physician Office
Facility Name	WEST COAST NEONATOLOGY INC
Street	9332 STATE ROAD 54 SUITE 407
City	TRINITY
State	FL
ZIP	34655
Phone	727 767-8988
CertificateType	4
CertificateEffectiveDate	3/5/2024
CertificateExpirationDate	3/4/2026
FacilityType	Waiver

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