10D2005381 CLIA NUMBER - DAVID HERSON MD PA

Laboratory Demographics

  • CLIA Code: 10D2005381
  • Facility Name: DAVID HERSON MD PA
  • Facility Address: 21756 STATE RD 54 STE 102A
    LUTZ, FL
    ZIP 33549
  • Facility Phone: 813 443-5817
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID M. HERSON
  • NPI Number: 1316942030
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2005381
LAB Type Physician Office
Facility Name DAVID HERSON MD PA
Street 21756 STATE RD 54 STE 102A
City LUTZ
State FL
ZIP 33549
Phone 813 443-5817
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2024
Certificate Expiration Date 3/25/2026
Facility Type Physician Office
Lab Director DAVID M. HERSON

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