10D2328606 CLIA NUMBER - OLYMPIC CONCIERGE MEDICINE

Laboratory Demographics

  • CLIA Code: 10D2328606
  • Facility Name: OLYMPIC CONCIERGE MEDICINE
  • Facility Address: 25200 SAWYER FRANCIS LN
    LUTZ, FL
    ZIP 33559
  • Facility Phone: 813 670-8915
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUSTIN D. BURKHOLDER
  • NPI Number: 1154201424
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2328606
LAB Type Physician Office
Facility Name OLYMPIC CONCIERGE MEDICINE
Street 25200 SAWYER FRANCIS LN
City LUTZ
State FL
ZIP 33559
Phone 813 670-8915
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2025
Certificate Expiration Date 8/12/2027
Facility Type Physician Office
Lab Director JUSTIN D. BURKHOLDER

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