10D2068957 CLIA NUMBER - GENERATION SPAN HEALTHCARE

Laboratory Demographics

  • CLIA Code: 10D2068957
  • Facility Name: GENERATION SPAN HEALTHCARE
  • Facility Address: 6271 WILLIAMS RD
    TALLAHASSEE, FL
    ZIP 32311
  • Facility Phone: 850 264-9070
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: FLORENCE P. BAMGBOSE
  • NPI Number: 1275963662
  • Taxonomy: 363LG0600X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2068957
LAB Type Practitioner Other
Facility Name GENERATION SPAN HEALTHCARE
Street 6271 WILLIAMS RD
City TALLAHASSEE
State FL
ZIP 32311
Phone 850 264-9070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Practitioner Other
Lab Director FLORENCE P. BAMGBOSE

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