10D2151027 CLIA NUMBER - VERIMED HEALTH GROUP BRANDON, LLC

Laboratory Demographics

CLIA Number: 10D2151027

Facility Name: VERIMED HEALTH GROUP BRANDON, LLC

Facility Address:
500 VONDERBURG DR STE 310
BRANDON, FL
ZIP 33511
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Facility Phone Number: 813 324-8253

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003392390

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2151027
LAB Type	Physician Office
Facility Name	VERIMED HEALTH GROUP BRANDON, LLC
Street	500 VONDERBURG DR STE 310
City	BRANDON
State	FL
ZIP	33511
Phone	813 324-8253
CertificateType	4
CertificateEffectiveDate	7/10/2022
CertificateExpirationDate	7/9/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024