10D2059642 CLIA NUMBER - DEMETRA BENNETT ARNP LLC

Laboratory Demographics

  • CLIA Code: 10D2059642
  • Facility Name: DEMETRA BENNETT ARNP LLC
  • Facility Address: 930 MARCUM RD STE 5
    LAKELAND, FL
    ZIP 33809
  • Facility Phone: (863) 940-4886
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DEMETRA BENNETT
  • NPI Number: 1184676025
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2059642
LAB Type Practitioner Other
Facility Name DEMETRA BENNETT ARNP LLC
Street 930 MARCUM RD STE 5
City LAKELAND
State FL
ZIP 33809
Phone 8639404886
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2025
Certificate Expiration Date 5/27/2027
Facility Type Practitioner Other
Lab Director DEMETRA BENNETT

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This page was last updated on: 5/18/2026