10D2222578 CLIA NUMBER - CLARK CLINIC INC

Laboratory Demographics

  • CLIA Code: 10D2222578
  • Facility Name: CLARK CLINIC INC
  • Facility Address: 12620 CURLEY STREET
    SAN ANTONIO, FL
    ZIP 33576
  • Facility Phone: 352 793-2441
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LOWELL F. CLARK
  • NPI Number: 1225661481
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2222578
LAB Type Physician Office
Facility Name CLARK CLINIC INC
Street 12620 CURLEY STREET
City SAN ANTONIO
State FL
ZIP 33576
Phone 352 793-2441
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Physician Office
Lab Director LOWELL F. CLARK

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