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3901 66TH ST N STE 202
SAINT PETERSBURG, FL 33709
Phone: (727) 345-8519
County: Pinellas

Mailing Address

3901 66TH ST N STE 202
SAINT PETERSBURG, FL 33709
County: Pinellas
Accredited by: College of American Pathologists

Emergency Actions:

None
Facility/Provider Type: Clinical Laboratory
Administrator: JOHN P WILLIAMS DO
Financial Officer: CHETAN DESAI
Owner/Licensee: WEST CENTRAL GASTROENTEROLOGY LLP
Owner/Licensee Since: 10/12/2010
NamePositionOwnership
CHETAN DESAI 3%
DAVID BECKER 3%
JACOB POTHEN 3%
KLEIN HOWARD 3%
SEENA SALYANI 0%
Profit Status: For-Profit
Licensed Beds: Not Available
AHCA Number (File Number): 26983108
CLIA Number: 10D1097508
AHCA Field Office: 05
License Number: 800025405
Current License Effective: 10/12/2016
Expires: 10/11/2018
License Status: LICENSED

Services/Characteristics:

Not Available


Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.
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