10D2275173 CLIA NUMBER - BAYCARE LIFE MANAGEMENT, INC

Laboratory Demographics

  • CLIA Code: 10D2275173
  • Facility Name: BAYCARE LIFE MANAGEMENT, INC
  • Facility Address: 2727 W DR MARTIN LUTHER KING JR BLVD - STE 640
    TAMPA, FL
    ZIP 33607
  • Facility Phone: (727) 315-8664
  • Facility Type: Other - BEHAVIORAL HEALTH CLINIC
  • Facility Type: Waiver
  • Lab Director: JENNY GONATOS
  • NPI Number: 1225290851
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2275173
LAB Type Other - BEHAVIORAL HEALTH CLINIC
Facility Name BAYCARE LIFE MANAGEMENT, INC
Street 2727 W DR MARTIN LUTHER KING JR BLVD - STE 640
City TAMPA
State FL
ZIP 33607
Phone 7273158664
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Other - BEHAVIORAL HEALTH CLINIC
Lab Director JENNY GONATOS

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This page was last updated on: 6/29/2026