10D2125391 CLIA NUMBER - BAYCARE OUTREACH LAB AT BARTOW REGIONAL MED CTR

Laboratory Demographics

  • CLIA Code: 10D2125391
  • Facility Name: BAYCARE OUTREACH LAB AT BARTOW REGIONAL MED CTR
  • Facility Address: 2000 OSPREY BLVD STE 204
    BARTOW, FL
    ZIP 33830
  • Facility Phone: 800 324-7853
  • Facility Type: Other - LAB COLLECTION STATION
  • Facility Type: Waiver
  • Lab Director: JESS R. BAKER
  • NPI Number: 1275774127
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 10D2125391
LAB Type Other - LAB COLLECTION STATION
Facility Name BAYCARE OUTREACH LAB AT BARTOW REGIONAL MED CTR
Street 2000 OSPREY BLVD STE 204
City BARTOW
State FL
ZIP 33830
Phone 800 324-7853
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2025
Certificate Expiration Date 2/6/2027
Facility Type Other - LAB COLLECTION STATION
Lab Director JESS R. BAKER

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