10D2305362 CLIA NUMBER - ILLUMINATED MIDWIFERY LLC

Laboratory Demographics

  • CLIA Code: 10D2305362
  • Facility Name: ILLUMINATED MIDWIFERY LLC
  • Facility Address: 6129 WILLOWSIDE ST
    PALMETTO, FL
    ZIP 34221
  • Facility Phone: 813 444-6007
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KITTY M. LAKEY
  • NPI Number: 1194572420
  • Taxonomy: 176B00000X - Midwife

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CLIA Record

Field Name Field Value
CLIA Number 10D2305362
LAB Type Practitioner Other
Facility Name ILLUMINATED MIDWIFERY LLC
Street 6129 WILLOWSIDE ST
City PALMETTO
State FL
ZIP 34221
Phone 813 444-6007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2024
Certificate Expiration Date 5/29/2026
Facility Type Practitioner Other
Lab Director KITTY M. LAKEY

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