10D2192715 CLIA NUMBER - FLORIDA MEDICAL SPECIALISTS LLC DBA BRADENTON PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D2192715
  • Facility Name: FLORIDA MEDICAL SPECIALISTS LLC DBA BRADENTON PRIMARY CARE
  • Facility Address: 4502 CORTEZ RD - STE 205
    BRADENTON, FL
    ZIP 34210
  • Facility Phone: 941 259-8505
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUGUNA KONA
  • NPI Number: 1609403088
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2192715
LAB Type Physician Office
Facility Name FLORIDA MEDICAL SPECIALISTS LLC DBA BRADENTON PRIMARY CARE
Street 4502 CORTEZ RD - STE 205
City BRADENTON
State FL
ZIP 34210
Phone 941 259-8505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Physician Office
Lab Director SUGUNA KONA

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