10D2298249 CLIA NUMBER - BAYCARE OUTPATIENT IMAGING, LLC

Laboratory Demographics

  • CLIA Code: 10D2298249
  • Facility Name: BAYCARE OUTPATIENT IMAGING, LLC
  • Facility Address: 635 1ST ST NORTH - STE 101
    WINTER HAVEN, FL
    ZIP 33881
  • Facility Phone: 863 298-3388
  • Facility Type: Other - OUTPATIENT IMAGING CENTER
  • Facility Type: Waiver
  • Lab Director: BRET HENRICKS
  • NPI Number: 1629853015
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2298249
LAB Type Other - OUTPATIENT IMAGING CENTER
Facility Name BAYCARE OUTPATIENT IMAGING, LLC
Street 635 1ST ST NORTH - STE 101
City WINTER HAVEN
State FL
ZIP 33881
Phone 863 298-3388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Other - OUTPATIENT IMAGING CENTER
Lab Director BRET HENRICKS

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