10D1087468 CLIA NUMBER - PRIMECARE AT PORT ORANGE

Laboratory Demographics

  • CLIA Code: 10D1087468
  • Facility Name: PRIMECARE AT PORT ORANGE
  • Facility Address: 1327 SAXON DR
    NEW SMYRNA BEACH, FL
    ZIP 32169
  • Facility Phone: 386 274-2212
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: J CAROL GRIGG MD
  • NPI Number: 1649601485
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D1087468
LAB Type Physician Office
Facility Name PRIMECARE AT PORT ORANGE
Street 1327 SAXON DR
City NEW SMYRNA BEACH
State FL
ZIP 32169
Phone 386 274-2212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type Physician Office
Lab Director J CAROL GRIGG MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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