10D0960543 CLIA NUMBER - PHYSICIAN CARE OF KEYSTONE

Laboratory Demographics

  • CLIA Code: 10D0960543
  • Facility Name: PHYSICIAN CARE OF KEYSTONE
  • Facility Address: 6542 TRIEST AVENUE
    KEYSTONE HEIGHTS, FL
    ZIP 32656
  • Facility Phone: 352 473-7288
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VICKI WLOCK
  • NPI Number: 1154512432
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0960543
LAB Type Physician Office
Facility Name PHYSICIAN CARE OF KEYSTONE
Street 6542 TRIEST AVENUE
City KEYSTONE HEIGHTS
State FL
ZIP 32656
Phone 352 473-7288
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2025
Certificate Expiration Date 6/4/2027
Facility Type Physician Office
Lab Director VICKI WLOCK

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