10D2254086 CLIA NUMBER - LAKESIDE CLINIC LLC DBA MEDMARK TREATMENT CENTERS CLEARWATER

Laboratory Demographics

  • CLIA Code: 10D2254086
  • Facility Name: LAKESIDE CLINIC LLC DBA MEDMARK TREATMENT CENTERS CLEARWATER
  • Facility Address: 13700 58TH STREET N
    CLEARWATER, FL
    ZIP 33760
  • Facility Phone: 727 223-3545
  • Facility Type: Other - NARCOTIC TREATMENT PROGRA
  • Facility Type: Waiver
  • Lab Director: HERBERT GERSH
  • NPI Number: 1992162879
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2254086
LAB Type Other - NARCOTIC TREATMENT PROGRA
Facility Name LAKESIDE CLINIC LLC DBA MEDMARK TREATMENT CENTERS CLEARWATER
Street 13700 58TH STREET N
City CLEARWATER
State FL
ZIP 33760
Phone 727 223-3545
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Other - NARCOTIC TREATMENT PROGRA
Lab Director HERBERT GERSH

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