10D2001937 CLIA NUMBER - MARCO ISLAND MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 10D2001937
  • Facility Name: MARCO ISLAND MEDICAL CENTER
  • Facility Address: 531 BALD EAGLE DR
    MARCO ISLAND, FL
    ZIP 34145
  • Facility Phone: 239 393-2000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH P. VICKARYOUS
  • NPI Number: 1164751400
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2001937
LAB Type Physician Office
Facility Name MARCO ISLAND MEDICAL CENTER
Street 531 BALD EAGLE DR
City MARCO ISLAND
State FL
ZIP 34145
Phone 239 393-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Physician Office
Lab Director JOSEPH P. VICKARYOUS

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