10D1042807 CLIA NUMBER - LIGHTSHARE BEHAVIORAL WELLNESS & RECOVERY, INC

Laboratory Demographics

  • CLIA Code: 10D1042807
  • Facility Name: LIGHTSHARE BEHAVIORAL WELLNESS & RECOVERY, INC
  • Facility Address: 1750 17TH ST BLDG J-2, K-2
    SARASOTA, FL
    ZIP 34234
  • Facility Phone: 941 366-5333
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MARIO OLIVA
  • NPI Number: 1881264901
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 10D1042807
LAB Type Other
Facility Name LIGHTSHARE BEHAVIORAL WELLNESS & RECOVERY, INC
Street 1750 17TH ST BLDG J-2, K-2
City SARASOTA
State FL
ZIP 34234
Phone 941 366-5333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2023
Certificate Expiration Date 7/10/2025
Facility Type Other
Lab Director MARIO OLIVA

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This page was last updated on: 3/20/2025