10D2193124 CLIA NUMBER - VAXONSITE LLC

Laboratory Demographics

  • CLIA Code: 10D2193124
  • Facility Name: VAXONSITE LLC
  • Facility Address: 1434 JAM LANE
    ODESSA, FL
    ZIP 33556
  • Facility Phone: 888 385-4555
  • Facility Type: Other - ON-SITE CLINICS
  • Facility Type: Waiver
  • Lab Director: CASEY O DONNELL
  • NPI Number: 1982152054
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2193124
LAB Type Other - ON-SITE CLINICS
Facility Name VAXONSITE LLC
Street 1434 JAM LANE
City ODESSA
State FL
ZIP 33556
Phone 888 385-4555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Other - ON-SITE CLINICS
Lab Director CASEY O DONNELL

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