10D2101832 CLIA NUMBER - SOUTH COUNTY MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 10D2101832
  • Facility Name: SOUTH COUNTY MEDICAL CENTER
  • Facility Address: 579 S INDIANA AVE SUITE A
    ENGLEWOOD, FL
    ZIP 34223
  • Facility Phone: 941 960-9907
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. MONICA RIDER
  • NPI Number: 1811368095
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2101832
LAB Type Federally Qualified Health Center
Facility Name SOUTH COUNTY MEDICAL CENTER
Street 579 S INDIANA AVE SUITE A
City ENGLEWOOD
State FL
ZIP 34223
Phone 941 960-9907
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Federally Qualified Health Center
Lab Director DR. MONICA RIDER

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