10D2120825 CLIA NUMBER - JOHN M KILGORE MD

Laboratory Demographics

  • CLIA Code: 10D2120825
  • Facility Name: JOHN M KILGORE MD
  • Facility Address: 122 S MOON AVE
    BRANDON, FL
    ZIP 33511
  • Facility Phone: 813 502-6430
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN M. KILGORE
  • NPI Number: 1518140128
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D2120825
LAB Type Physician Office
Facility Name JOHN M KILGORE MD
Street 122 S MOON AVE
City BRANDON
State FL
ZIP 33511
Phone 813 502-6430
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2024
Certificate Expiration Date 10/24/2026
Facility Type Physician Office
Lab Director JOHN M. KILGORE

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