10D2002152 CLIA NUMBER - BAYCARE OUTPATIENT IMAGING VAN DYKE

Laboratory Demographics

  • CLIA Code: 10D2002152
  • Facility Name: BAYCARE OUTPATIENT IMAGING VAN DYKE
  • Facility Address: 4091 VAN DYKE RD
    LUTZ, FL
    ZIP 33558
  • Facility Phone: 800 324-7853
  • Facility Type: Other - DIAGNOSTIC CENTER
  • Facility Type: Waiver
  • Lab Director: DR. DMITRY BASCHINSKY
  • NPI Number: 1780970137
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2002152
LAB Type Other - DIAGNOSTIC CENTER
Facility Name BAYCARE OUTPATIENT IMAGING VAN DYKE
Street 4091 VAN DYKE RD
City LUTZ
State FL
ZIP 33558
Phone 800 324-7853
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Other - DIAGNOSTIC CENTER
Lab Director DR. DMITRY BASCHINSKY

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