10D0703998 CLIA NUMBER - RANDOLPH MEDICAL PRACTICES PA

Laboratory Demographics

  • CLIA Code: 10D0703998
  • Facility Name: RANDOLPH MEDICAL PRACTICES PA
  • Facility Address: 1847 SW BARNETT WAY
    LAKE CITY, FL
    ZIP 32025
  • Facility Phone: 386 755-1440
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TOMMY RANDOLPH
  • NPI Number: 1144320052
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0703998
LAB Type Physician Office
Facility Name RANDOLPH MEDICAL PRACTICES PA
Street 1847 SW BARNETT WAY
City LAKE CITY
State FL
ZIP 32025
Phone 386 755-1440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director TOMMY RANDOLPH

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