10D2321006 CLIA NUMBER - GREGORY L HENDERSON, MD, FACS, INC

Laboratory Demographics

  • CLIA Code: 10D2321006
  • Facility Name: GREGORY L HENDERSON, MD, FACS, INC
  • Facility Address: 1701 RICKENBACKER DR
    SUN CITY CENTER, FL
    ZIP 33573
  • Facility Phone: 813 634-8877
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HILDA MENDOZA
  • NPI Number: 1174711204
  • Taxonomy: 213ES0131X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 10D2321006
LAB Type Physician Office
Facility Name GREGORY L HENDERSON, MD, FACS, INC
Street 1701 RICKENBACKER DR
City SUN CITY CENTER
State FL
ZIP 33573
Phone 813 634-8877
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director HILDA MENDOZA

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