10D2210595 CLIA NUMBER - JI UNIVERSAL MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2210595
  • Facility Name: JI UNIVERSAL MEDICAL GROUP LLC
  • Facility Address: 8903 REGENTS PARK DR - STE 120
    TAMPA, FL
    ZIP 33647
  • Facility Phone: 813 577-2622
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JULIE IGILAR
  • NPI Number: 1811518111
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2210595
LAB Type Practitioner Other
Facility Name JI UNIVERSAL MEDICAL GROUP LLC
Street 8903 REGENTS PARK DR - STE 120
City TAMPA
State FL
ZIP 33647
Phone 813 577-2622
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Practitioner Other
Lab Director JULIE IGILAR

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