10D2214116 CLIA NUMBER - WELLNESS AND HYDRATION CLINIC LLC, THE

Laboratory Demographics

  • CLIA Code: 10D2214116
  • Facility Name: WELLNESS AND HYDRATION CLINIC LLC, THE
  • Facility Address: 580 LEXINGTON GREEN
    SANFORD, FL
    ZIP 32771
  • Facility Phone: 931 510-7783
  • Facility Type: Other - PRACTITIONER OFFICE
  • Facility Type: Waiver
  • Lab Director: BIANCA J. BURNETT
  • NPI Number: 1831789015
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2214116
LAB Type Other - PRACTITIONER OFFICE
Facility Name WELLNESS AND HYDRATION CLINIC LLC, THE
Street 580 LEXINGTON GREEN
City SANFORD
State FL
ZIP 32771
Phone 931 510-7783
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2025
Certificate Expiration Date 2/18/2027
Facility Type Other - PRACTITIONER OFFICE
Lab Director BIANCA J. BURNETT

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