10D0699538 CLIA NUMBER - CONCENTRA - BARTOW

Laboratory Demographics

CLIA Number: 10D0699538

Facility Name: CONCENTRA - BARTOW

Facility Address:
1750 N BROADWAY
BARTOW, FL
ZIP 33830
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Facility Phone Number: 863 533-2030

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609353598

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0699538
LAB Type	Physician Office
Facility Name	CONCENTRA - BARTOW
Street	1750 N BROADWAY
City	BARTOW
State	FL
ZIP	33830
Phone	863 533-2030
CertificateType	4
CertificateEffectiveDate	1/14/2024
CertificateExpirationDate	1/13/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024