10D2173308 CLIA NUMBER - FLORIDA GULF COAST UNIVERSITY BOARD OF TRUSTEES

Laboratory Demographics

  • CLIA Code: 10D2173308
  • Facility Name: FLORIDA GULF COAST UNIVERSITY BOARD OF TRUSTEES
  • Facility Address: 10501 FGCU BLVD SOUTH MARIEB HALL
    FORT MYERS, FL
    ZIP 33965
  • Facility Phone: 239 246-5152
  • Facility Type: Health Fair
  • Facility Type: Waiver
  • Lab Director: DR. LOLITA MELHADO
  • NPI Number: 1811520901
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2173308
LAB Type Health Fair
Facility Name FLORIDA GULF COAST UNIVERSITY BOARD OF TRUSTEES
Street 10501 FGCU BLVD SOUTH MARIEB HALL
City FORT MYERS
State FL
ZIP 33965
Phone 239 246-5152
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2025
Certificate Expiration Date 10/8/2027
Facility Type Health Fair
Lab Director DR. LOLITA MELHADO

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