10D0293302 CLIA NUMBER - BAYCARE MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 10D0293302
  • Facility Name: BAYCARE MEDICAL GROUP INC
  • Facility Address: 601 FIRST STREET NORTH
    WINTER HAVEN, FL
    ZIP 33881
  • Facility Phone: (863) 298-3338
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. LISA M. JARDINE
  • NPI Number: 1508436544
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D0293302
LAB Type Physician Office
Facility Name BAYCARE MEDICAL GROUP INC
Street 601 FIRST STREET NORTH
City WINTER HAVEN
State FL
ZIP 33881
Phone 8632983338
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DR. LISA M. JARDINE

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This page was last updated on: 5/18/2026