10D2308142 CLIA NUMBER - HEALTHCARE NETWORK COMMUNITY OUTREACH

Laboratory Demographics

  • CLIA Code: 10D2308142
  • Facility Name: HEALTHCARE NETWORK COMMUNITY OUTREACH
  • Facility Address: 1454 MADISON AVE W
    IMMOKALEE, FL
    ZIP 34142
  • Facility Phone: 239 658-3131
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: JAIMENEE KHEMRAJ
  • NPI Number: 1073707741
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2308142
LAB Type Federally Qualified Health Center
Facility Name HEALTHCARE NETWORK COMMUNITY OUTREACH
Street 1454 MADISON AVE W
City IMMOKALEE
State FL
ZIP 34142
Phone 239 658-3131
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Federally Qualified Health Center
Lab Director JAIMENEE KHEMRAJ

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