10D2121255 CLIA NUMBER - EVOLUTION PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D2121255
  • Facility Name: EVOLUTION PRIMARY CARE
  • Facility Address: 11264 BOYETTE RD
    RIVERVIEW, FL
    ZIP 33569
  • Facility Phone: 813 672-2014
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW A. DOWDY
  • NPI Number: 1609327311
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2121255
LAB Type Physician Office
Facility Name EVOLUTION PRIMARY CARE
Street 11264 BOYETTE RD
City RIVERVIEW
State FL
ZIP 33569
Phone 813 672-2014
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2024
Certificate Expiration Date 11/1/2026
Facility Type Physician Office
Lab Director MATTHEW A. DOWDY

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