10D2306590 CLIA NUMBER - SEASIDE WELLNESS PRIMARY CARE PLLC

Laboratory Demographics

  • CLIA Code: 10D2306590
  • Facility Name: SEASIDE WELLNESS PRIMARY CARE PLLC
  • Facility Address: 501 S LINCOLN AVE SUITE 22
    CLEARWATER, FL
    ZIP 33756
  • Facility Phone: 727 357-7828
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: KRISTA B. SHENKMAN
  • NPI Number: 1023864121
  • Taxonomy: 363LG0600X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2306590
LAB Type Practitioner Other
Facility Name SEASIDE WELLNESS PRIMARY CARE PLLC
Street 501 S LINCOLN AVE SUITE 22
City CLEARWATER
State FL
ZIP 33756
Phone 727 357-7828
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/20/2024
Certificate Expiration Date 6/19/2026
Facility Type Practitioner Other
Lab Director KRISTA B. SHENKMAN

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