10D2286958 CLIA NUMBER - GREENBROOK MEDICAL PRACTICE, PLLC

Laboratory Demographics

  • CLIA Code: 10D2286958
  • Facility Name: GREENBROOK MEDICAL PRACTICE, PLLC
  • Facility Address: 10453 STELLING DR
    RIVERVIEW, FL
    ZIP 33578
  • Facility Phone: 813 709-7771
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJ P. MACHHAR
  • NPI Number: 1457014342
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2286958
LAB Type Physician Office
Facility Name GREENBROOK MEDICAL PRACTICE, PLLC
Street 10453 STELLING DR
City RIVERVIEW
State FL
ZIP 33578
Phone 813 709-7771
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2025
Certificate Expiration Date 8/6/2027
Facility Type Physician Office
Lab Director RAJ P. MACHHAR

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