10D2265873 CLIA NUMBER - 360 MEDICAL CARE, LLC DBA 360 INFUSION CENTER

Laboratory Demographics

  • CLIA Code: 10D2265873
  • Facility Name: 360 MEDICAL CARE, LLC DBA 360 INFUSION CENTER
  • Facility Address: 14107 CORTEZ BLVD
    BROOKSVILLE, FL
    ZIP 34613
  • Facility Phone: 352 549-9962
  • Facility Type: Other - INFUSION CENTER
  • Facility Type: Waiver
  • Lab Director: GAUTAM THAKKAR
  • NPI Number: 1649861790
  • Taxonomy: 261QI0500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2265873
LAB Type Other - INFUSION CENTER
Facility Name 360 MEDICAL CARE, LLC DBA 360 INFUSION CENTER
Street 14107 CORTEZ BLVD
City BROOKSVILLE
State FL
ZIP 34613
Phone 352 549-9962
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2024
Certificate Expiration Date 8/2/2026
Facility Type Other - INFUSION CENTER
Lab Director GAUTAM THAKKAR

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