10D1034634 CLIA NUMBER - OPTUMCARE FLORIDA LLC

Laboratory Demographics

  • CLIA Code: 10D1034634
  • Facility Name: OPTUMCARE FLORIDA LLC
  • Facility Address: 1082 E BRANDON BLVD
    BRANDON, FL
    ZIP 33511
  • Facility Phone: 813 689-9900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIRIAM GOMEZ
  • NPI Number: 1659749943
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 10D1034634
LAB Type Physician Office
Facility Name OPTUMCARE FLORIDA LLC
Street 1082 E BRANDON BLVD
City BRANDON
State FL
ZIP 33511
Phone 813 689-9900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Physician Office
Lab Director MIRIAM GOMEZ

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