10D2296665 CLIA NUMBER - JEREMY D MCCONNELL, MD, PA

Laboratory Demographics

  • CLIA Code: 10D2296665
  • Facility Name: JEREMY D MCCONNELL, MD, PA
  • Facility Address: 5601 21ST AVE W - STE D
    BRADENTON, FL
    ZIP 34209
  • Facility Phone: 941 792-8383
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEREMY D. MCCONNELL
  • NPI Number: 1700871969
  • Taxonomy: 207QS1201X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2296665
LAB Type Physician Office
Facility Name JEREMY D MCCONNELL, MD, PA
Street 5601 21ST AVE W - STE D
City BRADENTON
State FL
ZIP 34209
Phone 941 792-8383
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Physician Office
Lab Director JEREMY D. MCCONNELL

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