10D2020534 CLIA NUMBER - HUGHES DIRECT PRIMARY CARE, LLC

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Laboratory Demographics

CLIA Number: 10D2020534

Facility Name: HUGHES DIRECT PRIMARY CARE, LLC

Facility Address:
13731 METROPOLIS AVE
FORT MYERS, FL
ZIP 33912
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Facility Phone Number: 239 561-5776

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1679138689

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2020534
LAB Type	Physician Office
Facility Name	HUGHES DIRECT PRIMARY CARE, LLC
Street	13731 METROPOLIS AVE
City	FORT MYERS
State	FL
ZIP	33912
Phone	239 561-5776
CertificateType	4
CertificateEffectiveDate	10/8/2023
CertificateExpirationDate	10/7/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024