10D2158251 CLIA NUMBER - ADVANTAGE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D2158251
  • Facility Name: ADVANTAGE PRIMARY CARE
  • Facility Address: 20212 E PENNSYLVANIA AVE STE B
    DUNNELLON, FL
    ZIP 34432
  • Facility Phone: 352 484-0422
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRACY RIDDLE
  • NPI Number: 1871062307
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2158251
LAB Type Physician Office
Facility Name ADVANTAGE PRIMARY CARE
Street 20212 E PENNSYLVANIA AVE STE B
City DUNNELLON
State FL
ZIP 34432
Phone 352 484-0422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2024
Certificate Expiration Date 11/25/2026
Facility Type Physician Office
Lab Director TRACY RIDDLE

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