10D2094462 CLIA NUMBER - BRANDON PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 10D2094462
  • Facility Name: BRANDON PLASTIC SURGERY
  • Facility Address: 500 VONERBURG DR STE 110W
    BRANDON, FL
    ZIP 33511
  • Facility Phone: 813 681-5709
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARVIN F. SHIENBAUM
  • NPI Number: 1720575004
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2094462
LAB Type Physician Office
Facility Name BRANDON PLASTIC SURGERY
Street 500 VONERBURG DR STE 110W
City BRANDON
State FL
ZIP 33511
Phone 813 681-5709
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Physician Office
Lab Director MARVIN F. SHIENBAUM

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