FLORIDA MEDICAL CLINIC PATHOLOGY LAB (FLORIDA MEDICAL CLINIC, LLC) NPI 1003036237

Pathology (Anatomic Pathology & Clinical Pathology) in Tampa, FL

NPI 1003036237 Organization Pathology Anatomic Pathology & Clinical Pathology CLIA Number 10D1041696 CLIA Certificate of Accreditation

About FLORIDA MEDICAL CLINIC PATHOLOGY LAB (FLORIDA MEDICAL CLINIC, LLC)

Florida Medical Clinic Pathology Lab (florida Medical Clinic, Llc) is a provider established in Tampa, Florida specializing in pathology (anatomic pathology & clinical pathology) . The NPI number of Florida Medical Clinic Pathology Lab (florida Medical Clinic, Llc) is 1003036237 and was assigned on April 2007. The practitioner's primary taxonomy code is 207ZP0102X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Florida Medical Clinic Pathology Lab (florida Medical Clinic, Llc) operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Florida Medical Clinic Pathology Lab. The authorized official of this NPI record is Joe I Delatorre (Ceo)

The CLIA number of Florida Medical Clinic Pathology Lab is 10D1041696 registered as a "independent" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued to Florida Medical Clinic Pathology Lab on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

NPI

1003036237

Provider NameFLORIDA MEDICAL CLINIC PATHOLOGY LAB (FLORIDA MEDICAL CLINIC, LLC)
Provider Location Address17401 COMMERCE PARK BLVD STE 108 TAMPA, FL 33647
Provider Mailing Address38135 MARKET SQ ZEPHYRHILLS, FL 33542
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Other Organization NameFLORIDA MEDICAL CLINIC PATHOLOGY LAB
Other Name TypeDoing Business As (3)
Enumeration Date04-30-2007
Last Update Date02-21-2020


Primary Taxonomy

Taxonomy Code207ZP0102X
ClassificationPathology
TypeAllopathic & Osteopathic Physicians
SpecializationAnatomic Pathology & Clinical Pathology
Taxonomy DescriptionA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

Business Address

FLORIDA MEDICAL CLINIC PATHOLOGY LAB
17401 COMMERCE PARK BLVD STE 108
TAMPA, FL
ZIP 33647
Phone: (813) 782-8311

Get Directions


Mailing Address

FLORIDA MEDICAL CLINIC PATHOLOGY LAB
38135 MARKET SQ
ZEPHYRHILLS, FL
ZIP 33542
Phone: (813) 780-1255
Fax: (813) 780-9773



Secondary Locations

38117 Market Sq
Zephyrhills, FL 33542
(813) 779-7687

Authorized Official

Authorized Official Name JOE I DELATORRE
Authorized Official TitleCEO
Authorized Official Phone(813) 780-8440

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003036237 is:

CLIA Number10D1041696
Facility TypeINDEPENDENT
Certificate TypeCertificate of Accreditation

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineNo

Taxonomy Description: a pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
800020546OTHER (01)FL
690006221OTHER (01)FL

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.