10D2008586 CLIA NUMBER - HOMELAND WELLNESS LLC

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Laboratory Demographics

CLIA Number: 10D2008586

Facility Name: HOMELAND WELLNESS LLC

Facility Address:
19199 UMBERLAND PLACE
LAND O LAKES, FL
ZIP 34638
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Facility Phone Number: 813 433-1669

Facility Type: Health Fair

Certificate Type: Waiver

NPI Number: 1760704308

Taxonomy: 261QC1800X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2008586
LAB Type	Health Fair
Facility Name	HOMELAND WELLNESS LLC
Street	19199 UMBERLAND PLACE
City	LAND O LAKES
State	FL
ZIP	34638
Phone	813 433-1669
CertificateType	4
CertificateEffectiveDate	6/14/2022
CertificateExpirationDate	6/13/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024