10D1057815 CLIA NUMBER - PUTNAM FAMILY CARE INC

Laboratory Demographics

  • CLIA Code: 10D1057815
  • Facility Name: PUTNAM FAMILY CARE INC
  • Facility Address: 6101 CRILL AVE
    PALATKA, FL
    ZIP 32177
  • Facility Phone: 386 326-1225
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DEREK S. BOHN
  • NPI Number: 1205840519
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1057815
LAB Type Physician Office
Facility Name PUTNAM FAMILY CARE INC
Street 6101 CRILL AVE
City PALATKA
State FL
ZIP 32177
Phone 386 326-1225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Physician Office
Lab Director DR. DEREK S. BOHN

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