10D2161987 CLIA NUMBER - PRIMARY CARE OF ORANGE CITY

Laboratory Demographics

  • CLIA Code: 10D2161987
  • Facility Name: PRIMARY CARE OF ORANGE CITY
  • Facility Address: 135 E MINNESOTA AVE
    ORANGE CITY, FL
    ZIP 32763
  • Facility Phone: 386 316-5439
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN CROKER
  • NPI Number: 1003167073
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2161987
LAB Type Physician Office
Facility Name PRIMARY CARE OF ORANGE CITY
Street 135 E MINNESOTA AVE
City ORANGE CITY
State FL
ZIP 32763
Phone 386 316-5439
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2025
Certificate Expiration Date 2/13/2027
Facility Type Physician Office
Lab Director JOHN CROKER

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This page was last updated on: 3/20/2025