10D2322959 CLIA NUMBER - INTERNAL MEDICINE MD LLC

Laboratory Demographics

  • CLIA Code: 10D2322959
  • Facility Name: INTERNAL MEDICINE MD LLC
  • Facility Address: 3633 LITTLE RD, SUITE 103
    TRINITY, FL
    ZIP 34655
  • Facility Phone: 727 997-1635
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN HANNA
  • NPI Number: 1801683388
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2322959
LAB Type Physician Office
Facility Name INTERNAL MEDICINE MD LLC
Street 3633 LITTLE RD, SUITE 103
City TRINITY
State FL
ZIP 34655
Phone 727 997-1635
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2025
Certificate Expiration Date 4/29/2027
Facility Type Physician Office
Lab Director JOHN HANNA

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