10D2005121 CLIA NUMBER - IKER LEYCEGUI MD PA

Laboratory Demographics

  • CLIA Code: 10D2005121
  • Facility Name: IKER LEYCEGUI MD PA
  • Facility Address: 145 CENTRAL PARK W STE 101
    PORT SAINT LUCIE, FL
    ZIP 34983
  • Facility Phone: 772 873-1919
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IKER LEYCEGUI
  • NPI Number: 1568556546
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2005121
LAB Type Physician Office
Facility Name IKER LEYCEGUI MD PA
Street 145 CENTRAL PARK W STE 101
City PORT SAINT LUCIE
State FL
ZIP 34983
Phone 772 873-1919
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Physician Office
Lab Director IKER LEYCEGUI

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