10D2059756 CLIA NUMBER - OPTUMCARE FLORIDA LLC

Laboratory Demographics

  • CLIA Code: 10D2059756
  • Facility Name: OPTUMCARE FLORIDA LLC
  • Facility Address: 2902 17TH ST
    SAINT CLOUD, FL
    ZIP 34769
  • Facility Phone: 407 957-0090
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONNA H. LESTER
  • NPI Number: 1053384214
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2059756
LAB Type Physician Office
Facility Name OPTUMCARE FLORIDA LLC
Street 2902 17TH ST
City SAINT CLOUD
State FL
ZIP 34769
Phone 407 957-0090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Physician Office
Lab Director DONNA H. LESTER

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