10D1104636 CLIA NUMBER - CENTER FOR RETINA AND MACULAR DISEASE

Laboratory Demographics

  • CLIA Code: 10D1104636
  • Facility Name: CENTER FOR RETINA AND MACULAR DISEASE
  • Facility Address: 2815 LAKELAND HILLS BLVD, STE 200
    LAKELAND, FL
    ZIP 33805
  • Facility Phone: 863 297-5400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HERSHEL PATEL
  • NPI Number: 1700060662
  • Taxonomy: 261QX0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1104636
LAB Type Physician Office
Facility Name CENTER FOR RETINA AND MACULAR DISEASE
Street 2815 LAKELAND HILLS BLVD, STE 200
City LAKELAND
State FL
ZIP 33805
Phone 863 297-5400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2025
Certificate Expiration Date 9/7/2027
Facility Type Physician Office
Lab Director HERSHEL PATEL

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