10D0289295 CLIA NUMBER - PHYSICIAN CARE WALK-IN CLINIC

Laboratory Demographics

  • CLIA Code: 10D0289295
  • Facility Name: PHYSICIAN CARE WALK-IN CLINIC
  • Facility Address: 620 VONDERBURG DR
    BRANDON, FL
    ZIP 33511
  • Facility Phone: 813 684-1777
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JERRY A. WISHIK MD
  • NPI Number: 1699710467
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0289295
LAB Type Physician Office
Facility Name PHYSICIAN CARE WALK-IN CLINIC
Street 620 VONDERBURG DR
City BRANDON
State FL
ZIP 33511
Phone 813 684-1777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2025
Certificate Expiration Date 9/29/2027
Facility Type Physician Office
Lab Director JERRY A. WISHIK MD

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