10D1034428 CLIA NUMBER - OPTUMCARE FLORIDA LLC

Laboratory Demographics

CLIA Number: 10D1034428

Facility Name: OPTUMCARE FLORIDA LLC

Facility Address:
5534 CORTEZ ROAD WEST
BRADENTON, FL
ZIP 34210
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Facility Phone Number: 941 757-2100

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1972997823

Taxonomy: 332900000X - Non-Pharmacy Dispensing Site
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

CLIA Record

Field Name	Field Value
CLIA Number	10D1034428
LAB Type	Physician Office
Facility Name	OPTUMCARE FLORIDA LLC
Street	5534 CORTEZ ROAD WEST
City	BRADENTON
State	FL
ZIP	34210
Phone	941 757-2100
CertificateType	4
CertificateEffectiveDate	12/2/2022
CertificateExpirationDate	12/1/2024
FacilityType	Waiver

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