10D2294665 CLIA NUMBER - BAYCARE OUTPATIENT IMAGING, LLC

Laboratory Demographics

  • CLIA Code: 10D2294665
  • Facility Name: BAYCARE OUTPATIENT IMAGING, LLC
  • Facility Address: 3198 N PARK RD - STE 102
    PLANT CITY, FL
    ZIP 33563
  • Facility Phone: 813 259-1902
  • Facility Type: Other - OP IMAGING CENTER
  • Facility Type: Waiver
  • Lab Director: RYAN TELFORD
  • NPI Number: 1376238642
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2294665
LAB Type Other - OP IMAGING CENTER
Facility Name BAYCARE OUTPATIENT IMAGING, LLC
Street 3198 N PARK RD - STE 102
City PLANT CITY
State FL
ZIP 33563
Phone 813 259-1902
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Other - OP IMAGING CENTER
Lab Director RYAN TELFORD

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