08D2249159 CLIA NUMBER - DIVERGENT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 08D2249159
  • Facility Name: DIVERGENT PRIMARY CARE
  • Facility Address: 1011 WALNUT STREET
    MILFORD, DE
    ZIP 19963
  • Facility Phone: (302) 734-2444
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TETSOMA O. TONWE
  • NPI Number: 1871249193
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 08D2249159
LAB Type Physician Office
Facility Name DIVERGENT PRIMARY CARE
Street 1011 WALNUT STREET
City MILFORD
State DE
ZIP 19963
Phone 3027342444
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Physician Office
Lab Director TETSOMA O. TONWE

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This page was last updated on: 5/18/2026