10D2261037 CLIA NUMBER - MOSAIC MEDICINE, PLLC

Laboratory Demographics

  • CLIA Code: 10D2261037
  • Facility Name: MOSAIC MEDICINE, PLLC
  • Facility Address: 3934 SR 64E
    BRADENTON, FL
    ZIP 34208
  • Facility Phone: 941 777-5665
  • Facility Type: Other - CONCIERGE PRACTICE
  • Facility Type: Waiver
  • Lab Director: CORY W. LUCAS
  • NPI Number: 1639827033
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2261037
LAB Type Other - CONCIERGE PRACTICE
Facility Name MOSAIC MEDICINE, PLLC
Street 3934 SR 64E
City BRADENTON
State FL
ZIP 34208
Phone 941 777-5665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2024
Certificate Expiration Date 5/24/2026
Facility Type Other - CONCIERGE PRACTICE
Lab Director CORY W. LUCAS

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