10D0938418 CLIA NUMBER - LAKE CITY REGIONAL MEDICAL GROUP LLC DBA HCA FLORIDA LAKE CITY PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D0938418
  • Facility Name: LAKE CITY REGIONAL MEDICAL GROUP LLC DBA HCA FLORIDA LAKE CITY PRIMARY CARE
  • Facility Address: 4225 NW AMERICAN LANE
    LAKE CITY, FL
    ZIP 32055
  • Facility Phone: 386 758-6141
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERNEST P. DE LEON
  • NPI Number: 1184910036
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0938418
LAB Type Physician Office
Facility Name LAKE CITY REGIONAL MEDICAL GROUP LLC DBA HCA FLORIDA LAKE CITY PRIMARY CARE
Street 4225 NW AMERICAN LANE
City LAKE CITY
State FL
ZIP 32055
Phone 386 758-6141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Physician Office
Lab Director ERNEST P. DE LEON

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This page was last updated on: 3/20/2025