10D2312046 CLIA NUMBER - MOGILISHETTY PLLC

Laboratory Demographics

  • CLIA Code: 10D2312046
  • Facility Name: MOGILISHETTY PLLC
  • Facility Address: 3400 LEE BLVD - #112
    LEHIGH ACRES, FL
    ZIP 33971
  • Facility Phone: 239 425-6633
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GAUTHAM MOGILISHETTY
  • NPI Number: 1972117109
  • Taxonomy: 207RN0300X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2312046
LAB Type Physician Office
Facility Name MOGILISHETTY PLLC
Street 3400 LEE BLVD - #112
City LEHIGH ACRES
State FL
ZIP 33971
Phone 239 425-6633
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Physician Office
Lab Director GAUTHAM MOGILISHETTY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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