10D2243272 CLIA NUMBER - INTEGRATIVE DIRECT PRIMARY CARE, INC

Laboratory Demographics

  • CLIA Code: 10D2243272
  • Facility Name: INTEGRATIVE DIRECT PRIMARY CARE, INC
  • Facility Address: 2590 NORTHBROOKE PLAZA DRIVE SUITE 106
    NAPLES, FL
    ZIP 34119
  • Facility Phone: 239 350-4900
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ELIZABETH SMITH
  • NPI Number: 1366014086
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2243272
LAB Type Practitioner Other
Facility Name INTEGRATIVE DIRECT PRIMARY CARE, INC
Street 2590 NORTHBROOKE PLAZA DRIVE SUITE 106
City NAPLES
State FL
ZIP 34119
Phone 239 350-4900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Practitioner Other
Lab Director ELIZABETH SMITH

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