10D2082314 CLIA NUMBER - ELITE DNA THERAPY SERVICES LLC

Laboratory Demographics

  • CLIA Code: 10D2082314
  • Facility Name: ELITE DNA THERAPY SERVICES LLC
  • Facility Address: 4310 METRO PARKWAY SUITE 205
    FORT MYERS, FL
    ZIP 33966
  • Facility Phone: 239 223-2751
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OMAR RIECHE
  • NPI Number: 1508231416
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2082314
LAB Type Physician Office
Facility Name ELITE DNA THERAPY SERVICES LLC
Street 4310 METRO PARKWAY SUITE 205
City FORT MYERS
State FL
ZIP 33966
Phone 239 223-2751
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Physician Office
Lab Director OMAR RIECHE

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