10D2200577 CLIA NUMBER - NORTH FLORIDA PRIMARY CARE, PLLC

Laboratory Demographics

  • CLIA Code: 10D2200577
  • Facility Name: NORTH FLORIDA PRIMARY CARE, PLLC
  • Facility Address: 4243 SW CAMBRIDGE GLEN
    LAKE CITY, FL
    ZIP 32024
  • Facility Phone: 386 292-7744
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL C. UKAEGBU
  • NPI Number: 1760093702
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2200577
LAB Type Physician Office
Facility Name NORTH FLORIDA PRIMARY CARE, PLLC
Street 4243 SW CAMBRIDGE GLEN
City LAKE CITY
State FL
ZIP 32024
Phone 386 292-7744
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Physician Office
Lab Director MICHAEL C. UKAEGBU

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