10D2197966 CLIA NUMBER - SHAW MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2197966
  • Facility Name: SHAW MEDICAL GROUP LLC
  • Facility Address: 947 BAREFOOT BLVD
    BAREFOOT BAY, FL
    ZIP 32976
  • Facility Phone: 321 593-6999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MURRAY A. KIMMEL
  • NPI Number: 1255884938
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2197966
LAB Type Physician Office
Facility Name SHAW MEDICAL GROUP LLC
Street 947 BAREFOOT BLVD
City BAREFOOT BAY
State FL
ZIP 32976
Phone 321 593-6999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Physician Office
Lab Director DR. MURRAY A. KIMMEL

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