10D0663690 CLIA NUMBER - FAIRWAY OAKS CENTER, LLC

Laboratory Demographics

  • CLIA Code: 10D0663690
  • Facility Name: FAIRWAY OAKS CENTER, LLC
  • Facility Address: 13806 N 46TH ST
    TAMPA, FL
    ZIP 33613
  • Facility Phone: 813 977-4214
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ANDRE MERVIL-LAMOUR
  • NPI Number: 1285622209
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0663690
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FAIRWAY OAKS CENTER, LLC
Street 13806 N 46TH ST
City TAMPA
State FL
ZIP 33613
Phone 813 977-4214
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ANDRE MERVIL-LAMOUR

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