10D2010828 CLIA NUMBER - LAKE CITY CANCER CARE LLC DBA CANCER CARE OF NORTH FLORIDA

Laboratory Demographics

  • CLIA Code: 10D2010828
  • Facility Name: LAKE CITY CANCER CARE LLC DBA CANCER CARE OF NORTH FLORIDA
  • Facility Address: 4520 W US HWY 90
    LAKE CITY, FL
    ZIP 32055
  • Facility Phone: 386 755-0601
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: WASEEMULLAH KHAN
  • NPI Number: 1427426469
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 10D2010828
LAB Type Ancillary Testing Site in Health Care Center
Facility Name LAKE CITY CANCER CARE LLC DBA CANCER CARE OF NORTH FLORIDA
Street 4520 W US HWY 90
City LAKE CITY
State FL
ZIP 32055
Phone 386 755-0601
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 Ancillary Testing Site in Health Care Center
Lab Director WASEEMULLAH KHAN

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