10D1092424 CLIA NUMBER - OSTEOPATHIC HERITAGE CORP

Laboratory Demographics

  • CLIA Code: 10D1092424
  • Facility Name: OSTEOPATHIC HERITAGE CORP
  • Facility Address: 959 W JEFFERSON ST
    BROOKSVILLE, FL
    ZIP 34601
  • Facility Phone: 352 799-7000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AUDREY BELLANT
  • NPI Number: 1316196744
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1092424
LAB Type Physician Office
Facility Name OSTEOPATHIC HERITAGE CORP
Street 959 W JEFFERSON ST
City BROOKSVILLE
State FL
ZIP 34601
Phone 352 799-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2024
Certificate Expiration Date 11/23/2026
Facility Type Physician Office
Lab Director AUDREY BELLANT

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