10D2120503 CLIA NUMBER - OHI WEST MEDICAL GROUP II, LLC

Laboratory Demographics

  • CLIA Code: 10D2120503
  • Facility Name: OHI WEST MEDICAL GROUP II, LLC
  • Facility Address: 13602 N 46TH ST
    TAMPA, FL
    ZIP 33613
  • Facility Phone: 813 778-0232
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS J. PUSATERI
  • NPI Number: 1043220221
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2120503
LAB Type Physician Office
Facility Name OHI WEST MEDICAL GROUP II, LLC
Street 13602 N 46TH ST
City TAMPA
State FL
ZIP 33613
Phone 813 778-0232
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2024
Certificate Expiration Date 10/17/2026
Facility Type Physician Office
Lab Director THOMAS J. PUSATERI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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