10D2261234 CLIA NUMBER - MY CHEM LAB LLC

Laboratory Demographics

  • CLIA Code: 10D2261234
  • Facility Name: MY CHEM LAB LLC
  • Facility Address: 602 JACKSON ST
    WILDWOOD, FL
    ZIP 34785
  • Facility Phone: 866 359-5527
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: TAMICHA ANDERSON GOODEN
  • NPI Number: 1780457002
  • Taxonomy: 246RP1900X - Technician, Pathology

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CLIA Record

Field Name Field Value
CLIA Number 10D2261234
LAB Type Mobile Laboratory
Facility Name MY CHEM LAB LLC
Street 602 JACKSON ST
City WILDWOOD
State FL
ZIP 34785
Phone 866 359-5527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2024
Certificate Expiration Date 5/26/2026
Facility Type Mobile Laboratory
Lab Director TAMICHA ANDERSON GOODEN

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