10D2267638 CLIA NUMBER - OPTIMUM HOME HEALTH AGENCY

Laboratory Demographics

  • CLIA Code: 10D2267638
  • Facility Name: OPTIMUM HOME HEALTH AGENCY
  • Facility Address: 500 VONDERBURG DRIVE SUITE 205
    BRANDON, FL
    ZIP 33511
  • Facility Phone: 813 655-4949
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: GLADYS KANODEREKA
  • NPI Number: 1346984796
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 10D2267638
LAB Type Home Health Agency
Facility Name OPTIMUM HOME HEALTH AGENCY
Street 500 VONDERBURG DRIVE SUITE 205
City BRANDON
State FL
ZIP 33511
Phone 813 655-4949
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Home Health Agency
Lab Director GLADYS KANODEREKA

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