10D2071971 CLIA NUMBER - MD PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 10D2071971
  • Facility Name: MD PRIMARY CARE INC
  • Facility Address: 2215 NEBRASKA AVE STE 2B
    FORT PIERCE, FL
    ZIP 34950
  • Facility Phone: 772 302-3767
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHINTAN B. SHAH
  • NPI Number: 1033766027
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2071971
LAB Type Physician Office
Facility Name MD PRIMARY CARE INC
Street 2215 NEBRASKA AVE STE 2B
City FORT PIERCE
State FL
ZIP 34950
Phone 772 302-3767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2024
Certificate Expiration Date 1/21/2026
Facility Type Physician Office
Lab Director CHINTAN B. SHAH

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