10D2297595 CLIA NUMBER - PHILOTEMO HEALTH AND WELLNESS

Laboratory Demographics

  • CLIA Code: 10D2297595
  • Facility Name: PHILOTEMO HEALTH AND WELLNESS
  • Facility Address: 4010 W STATE ST
    TAMPA, FL
    ZIP 33609
  • Facility Phone: 813 355-0325
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: EDITH LORRAINE KAVOUKLIS
  • NPI Number: 1639850563
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2297595
LAB Type Practitioner Other
Facility Name PHILOTEMO HEALTH AND WELLNESS
Street 4010 W STATE ST
City TAMPA
State FL
ZIP 33609
Phone 813 355-0325
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2024
Certificate Expiration Date 1/17/2026
Facility Type Practitioner Other
Lab Director EDITH LORRAINE KAVOUKLIS

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