10D1036224 CLIA NUMBER - OUTPATIENT LAB-BIMINI SQUARE

Laboratory Demographics

  • CLIA Code: 10D1036224
  • Facility Name: OUTPATIENT LAB-BIMINI SQUARE
  • Facility Address: 414 CAPE CORAL PARKWAY E SUITE 101
    CAPE CORAL, FL
    ZIP 33904
  • Facility Phone: (239) 343-2938
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: KAREN BODEMAN
  • NPI Number: 1154070936
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 10D1036224
LAB Type Other
Facility Name OUTPATIENT LAB-BIMINI SQUARE
Street 414 CAPE CORAL PARKWAY E SUITE 101
City CAPE CORAL
State FL
ZIP 33904
Phone 2393432938
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Other
Lab Director KAREN BODEMAN

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This page was last updated on: 5/18/2026