10D2068592 CLIA NUMBER - SHARON NICKELL- OLM MD FAMILY MEDICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2068592
  • Facility Name: SHARON NICKELL- OLM MD FAMILY MEDICAL CENTER LLC
  • Facility Address: 2000 PREVATT STREET
    EUSTIS, FL
    ZIP 32726
  • Facility Phone: 352 357-2600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHARON A. NICKELL- OLM
  • NPI Number: 1407076052
  • Taxonomy: 207QH0002X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2068592
LAB Type Physician Office
Facility Name SHARON NICKELL- OLM MD FAMILY MEDICAL CENTER LLC
Street 2000 PREVATT STREET
City EUSTIS
State FL
ZIP 32726
Phone 352 357-2600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2023
Certificate Expiration Date 11/6/2025
Facility Type Physician Office
Lab Director SHARON A. NICKELL- OLM

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