10D2182314 CLIA NUMBER - RANDOLPH DIABETES AND WELLNESS

Laboratory Demographics

  • CLIA Code: 10D2182314
  • Facility Name: RANDOLPH DIABETES AND WELLNESS
  • Facility Address: 13047 W LINEBAUGH AVE STE 102
    TAMPA, FL
    ZIP 33626
  • Facility Phone: 813 475-6542
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIMBERLY T. RANDOLPH
  • NPI Number: 1609378991
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2182314
LAB Type Physician Office
Facility Name RANDOLPH DIABETES AND WELLNESS
Street 13047 W LINEBAUGH AVE STE 102
City TAMPA
State FL
ZIP 33626
Phone 813 475-6542
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Physician Office
Lab Director KIMBERLY T. RANDOLPH

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