Organization
DRS CLACK SPENCER WHITE & MCCORMACK PA
Active
Parent organization
DRS CLACK SPENCER WHITE & MCCORMACK PA
Other names
Sarasota Pathology
Organization subpart
Yes
Provider details
NPI number
Legal business name
DRS CLACK SPENCER WHITE & MCCORMACK PA
Authorized official
KEVIN M MCCORMACK M.D., PHD (PRESIDENT)
(941) 362-8900
Entity
Organization
Contact information
Practice address
2001 WEBBER ST, SARASOTA, FL 34239-5237
(941) 362-8900
(941) 362-8987
Mailing address
2001 WEBBER ST, SARASOTA, FL 34239-5237
(941) 362-8900
(941) 362-8987
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
LAB800000813
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D0296120
CMS CLIA CERTIFICATION
FL
01
—
L8218
BCBS OF FLORIDA
FL
01
—
LAB 80000813
AHCA CLINICAL LABORATORY LICENSE
FL
Enumeration date
10/22/2009
Last updated
03/27/2017
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