10D0895383 CLIA NUMBER - TAMPA GENERAL MEDICAL GROUP LABORATORY

Laboratory Demographics

  • CLIA Code: 10D0895383
  • Facility Name: TAMPA GENERAL MEDICAL GROUP LABORATORY
  • Facility Address: 2501 W KENNEDY BLVD
    TAMPA, FL
    ZIP 33609
  • Facility Phone: 813 394-1102
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. CASEY GOODEN
  • NPI Number: 1578800462
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0895383
LAB Type Community Clinic
Facility Name TAMPA GENERAL MEDICAL GROUP LABORATORY
Street 2501 W KENNEDY BLVD
City TAMPA
State FL
ZIP 33609
Phone 813 394-1102
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Community Clinic
Lab Director DR. CASEY GOODEN

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This page was last updated on: 3/20/2025