10D2009165 CLIA NUMBER - MANATEE DIAGNOSTIC CENTER

Laboratory Demographics

  • CLIA Code: 10D2009165
  • Facility Name: MANATEE DIAGNOSTIC CENTER
  • Facility Address: 300 RIVERSIDE DR E - STE 1400
    BRADENTON, FL
    ZIP 34208
  • Facility Phone: 941 747-3034
  • Facility Type: Other - INDEPENDENT DIAGNOSTIC T
  • Facility Type: Waiver
  • Lab Director: DR. BRET HENRICKS
  • NPI Number: 1972872604
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2009165
LAB Type Other - INDEPENDENT DIAGNOSTIC T
Facility Name MANATEE DIAGNOSTIC CENTER
Street 300 RIVERSIDE DR E - STE 1400
City BRADENTON
State FL
ZIP 34208
Phone 941 747-3034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Other - INDEPENDENT DIAGNOSTIC T
Lab Director DR. BRET HENRICKS

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This page was last updated on: 3/20/2025