10D2313772 CLIA NUMBER - PALM ENDOVASCULAR INSTITUTE

Laboratory Demographics

  • CLIA Code: 10D2313772
  • Facility Name: PALM ENDOVASCULAR INSTITUTE
  • Facility Address: 2344 CRESTOVER LN
    WESLEY CHAPEL, FL
    ZIP 33544
  • Facility Phone: 813 563-0917
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: AGAM PATEL
  • NPI Number: 1942989090
  • Taxonomy: 2085R0204X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2313772
LAB Type Practitioner Other
Facility Name PALM ENDOVASCULAR INSTITUTE
Street 2344 CRESTOVER LN
City WESLEY CHAPEL
State FL
ZIP 33544
Phone 813 563-0917
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 11/5/2026
Facility Type Practitioner Other
Lab Director AGAM PATEL

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