10D2079619 CLIA NUMBER - VERIMED HEALTH GROUP LAKELAND

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Laboratory Demographics

CLIA Number: 10D2079619

Facility Name: VERIMED HEALTH GROUP LAKELAND

Facility Address:
1417 LAKELAND HILLS BLVD STE 204
LAKELAND, FL
ZIP 33805
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Facility Phone Number: 813 415-5038

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1023422391

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2079619
LAB Type	Physician Office
Facility Name	VERIMED HEALTH GROUP LAKELAND
Street	1417 LAKELAND HILLS BLVD STE 204
City	LAKELAND
State	FL
ZIP	33805
Phone	813 415-5038
CertificateType	4
CertificateEffectiveDate	6/19/2022
CertificateExpirationDate	6/18/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024