10D1059559 CLIA NUMBER - KC INTEGRATIVE WELLNESS LLC

Laboratory Demographics

  • CLIA Code: 10D1059559
  • Facility Name: KC INTEGRATIVE WELLNESS LLC
  • Facility Address: 327 MEDCREST DRIVE UNIT A
    CRESTVIEW, FL
    ZIP 32536
  • Facility Phone: (850) 423-0761
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KATE R. LOPS
  • NPI Number: 1265299077
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1059559
LAB Type Physician Office
Facility Name KC INTEGRATIVE WELLNESS LLC
Street 327 MEDCREST DRIVE UNIT A
City CRESTVIEW
State FL
ZIP 32536
Phone 8504230761
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2026
Certificate Expiration Date 2/11/2028
Facility Type Physician Office
Lab Director KATE R. LOPS

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This page was last updated on: 5/18/2026