10D2040063 CLIA NUMBER - BROOKDALE BAYSHORE

Laboratory Demographics

  • CLIA Code: 10D2040063
  • Facility Name: BROOKDALE BAYSHORE
  • Facility Address: 4902 BAYSHORE BLVD
    TAMPA, FL
    ZIP 33611
  • Facility Phone: 813 835-4475
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JULIZA ANTONGIORGI
  • NPI Number: 1578865903
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2040063
LAB Type Assisted Living Facility
Facility Name BROOKDALE BAYSHORE
Street 4902 BAYSHORE BLVD
City TAMPA
State FL
ZIP 33611
Phone 813 835-4475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Assisted Living Facility
Lab Director JULIZA ANTONGIORGI

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