10D2103806 CLIA NUMBER - LAKELAND PHYSICIANS AND ASSOCIATES

Laboratory Demographics

  • CLIA Code: 10D2103806
  • Facility Name: LAKELAND PHYSICIANS AND ASSOCIATES
  • Facility Address: 1818 HARDEN BLVD STE 120
    LAKELAND, FL
    ZIP 33803
  • Facility Phone: 863 210-5640
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AVANTICA GONDI
  • NPI Number: 1427429281
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2103806
LAB Type Physician Office
Facility Name LAKELAND PHYSICIANS AND ASSOCIATES
Street 1818 HARDEN BLVD STE 120
City LAKELAND
State FL
ZIP 33803
Phone 863 210-5640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2025
Certificate Expiration Date 10/20/2027
Facility Type Physician Office
Lab Director AVANTICA GONDI

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