10D1032804 CLIA NUMBER - GULFCOAST FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 10D1032804
  • Facility Name: GULFCOAST FAMILY PRACTICE
  • Facility Address: 202 MANATEE AVE EAST
    BRADENTON, FL
    ZIP 34208
  • Facility Phone: 941 747-8272
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AHMAD SAHEBZAMANI
  • NPI Number: 1811176910
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1032804
LAB Type Physician Office
Facility Name GULFCOAST FAMILY PRACTICE
Street 202 MANATEE AVE EAST
City BRADENTON
State FL
ZIP 34208
Phone 941 747-8272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Physician Office
Lab Director AHMAD SAHEBZAMANI

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