10D2110442 CLIA NUMBER - OHI WEST MEDICAL GROUP II LLC

Laboratory Demographics

  • CLIA Code: 10D2110442
  • Facility Name: OHI WEST MEDICAL GROUP II LLC
  • Facility Address: 19021 N DALE MABRY HWY
    LUTZ, FL
    ZIP 33548
  • Facility Phone: 813 782-8311
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES A. SOTROP
  • NPI Number: 1003036237
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 10D2110442
LAB Type Physician Office
Facility Name OHI WEST MEDICAL GROUP II LLC
Street 19021 N DALE MABRY HWY
City LUTZ
State FL
ZIP 33548
Phone 813 782-8311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Physician Office
Lab Director JAMES A. SOTROP

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