10D2202148 CLIA NUMBER - BLUETAIL MEDICAL GROUP, LLC

Laboratory Demographics

  • CLIA Code: 10D2202148
  • Facility Name: BLUETAIL MEDICAL GROUP, LLC
  • Facility Address: 1875 VETERANS PARK DRIVE, SUITE #2201
    NAPLES, FL
    ZIP 34109
  • Facility Phone: 239 631-1960
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LUGA PODESTA
  • NPI Number: 1285986398
  • Taxonomy: 207XX0005X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2202148
LAB Type Physician Office
Facility Name BLUETAIL MEDICAL GROUP, LLC
Street 1875 VETERANS PARK DRIVE, SUITE #2201
City NAPLES
State FL
ZIP 34109
Phone 239 631-1960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/25/2024
Certificate Expiration Date 11/24/2026
Facility Type Physician Office
Lab Director LUGA PODESTA

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