10D0895348 CLIA NUMBER - UF HEALTH FAMILY MEDICINE - OLD TOWN

Laboratory Demographics

  • CLIA Code: 10D0895348
  • Facility Name: UF HEALTH FAMILY MEDICINE - OLD TOWN
  • Facility Address: 25827 SE HIGHWAY 19
    OLD TOWN, FL
    ZIP 32680
  • Facility Phone: 352 265-8067
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JASON G. KONOPACK
  • NPI Number: 1629138292
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0895348
LAB Type Physician Office
Facility Name UF HEALTH FAMILY MEDICINE - OLD TOWN
Street 25827 SE HIGHWAY 19
City OLD TOWN
State FL
ZIP 32680
Phone 352 265-8067
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 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Physician Office
Lab Director JASON G. KONOPACK

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