10D2004149 CLIA NUMBER - WELLNESS CLINIC OF BRANDON, LLC

Laboratory Demographics

  • CLIA Code: 10D2004149
  • Facility Name: WELLNESS CLINIC OF BRANDON, LLC
  • Facility Address: 203 W BLOOMINGDALE AVE
    BRANDON, FL
    ZIP 33511
  • Facility Phone: 813 654-1110
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. SYLVAN H. RIKER
  • NPI Number: 1245576685
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2004149
LAB Type Practitioner Other
Facility Name WELLNESS CLINIC OF BRANDON, LLC
Street 203 W BLOOMINGDALE AVE
City BRANDON
State FL
ZIP 33511
Phone 813 654-1110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Practitioner Other
Lab Director DR. SYLVAN H. RIKER

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