10D2099192 CLIA NUMBER - VITAL GENIX HEALTH AND WELLNESS LLC

Laboratory Demographics

  • CLIA Code: 10D2099192
  • Facility Name: VITAL GENIX HEALTH AND WELLNESS LLC
  • Facility Address: 125 WAYMONT COURT SUITE 11
    LAKE MARY, FL
    ZIP 32746
  • Facility Phone: 407 636-9663
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAUL E. TAMAYO
  • NPI Number: 1427428887
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2099192
LAB Type Physician Office
Facility Name VITAL GENIX HEALTH AND WELLNESS LLC
Street 125 WAYMONT COURT SUITE 11
City LAKE MARY
State FL
ZIP 32746
Phone 407 636-9663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2023
Certificate Expiration Date 7/21/2025
Facility Type Physician Office
Lab Director RAUL E. TAMAYO

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This page was last updated on: 6/4/2025