10D0983764 CLIA NUMBER - HAWTHORNE INN OF BRANDON

Laboratory Demographics

  • CLIA Code: 10D0983764
  • Facility Name: HAWTHORNE INN OF BRANDON
  • Facility Address: 859 W LUMSDEN RD
    BRANDON, FL
    ZIP 33511
  • Facility Phone: 813 661-8998
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: KIMLA MINER
  • NPI Number: 1952981771
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0983764
LAB Type Other
Facility Name HAWTHORNE INN OF BRANDON
Street 859 W LUMSDEN RD
City BRANDON
State FL
ZIP 33511
Phone 813 661-8998
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Other
Lab Director KIMLA MINER

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