10D2233592 CLIA NUMBER - LIVE OAK FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 10D2233592
  • Facility Name: LIVE OAK FAMILY PRACTICE LLC
  • Facility Address: 1304 OHIO AVE SOUTH
    LIVE OAK, FL
    ZIP 32064
  • Facility Phone: 386 364-0767
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MELISSA F. PETERS
  • NPI Number: 1134892201
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2233592
LAB Type Physician Office
Facility Name LIVE OAK FAMILY PRACTICE LLC
Street 1304 OHIO AVE SOUTH
City LIVE OAK
State FL
ZIP 32064
Phone 386 364-0767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type Physician Office
Lab Director MELISSA F. PETERS

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