10D2121255 CLIA NUMBER - EVOLUTION PRIMARY CARE

Laboratory Demographics

CLIA Number: 10D2121255

Facility Name: EVOLUTION PRIMARY CARE

Facility Address:
11264 BOYETTE RD
RIVERVIEW, FL
ZIP 33569
Get Directions

Facility Phone Number: 813 672-2014

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609327311

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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
CertificateType	4
CertificateEffectiveDate	11/2/2022
CertificateExpirationDate	11/1/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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