10D2301571 CLIA NUMBER - MENDING HEARTS PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 10D2301571
  • Facility Name: MENDING HEARTS PRIMARY CARE LLC
  • Facility Address: 7901 4TH ST NORTH - #8298
    SAINT PETERSBURG, FL
    ZIP 33702
  • Facility Phone: 813 278-1241
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: STEPHANIE N. BAILEY
  • NPI Number: 1245008333
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2301571
LAB Type Practitioner Other
Facility Name MENDING HEARTS PRIMARY CARE LLC
Street 7901 4TH ST NORTH - #8298
City SAINT PETERSBURG
State FL
ZIP 33702
Phone 813 278-1241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Practitioner Other
Lab Director STEPHANIE N. BAILEY

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