10D2254502 CLIA NUMBER - VG PRIMARY CARE, PLLC

Laboratory Demographics

  • CLIA Code: 10D2254502
  • Facility Name: VG PRIMARY CARE, PLLC
  • Facility Address: 5285 SUMMERLIN RD - STE E101
    FORT MYERS, FL
    ZIP 33919
  • Facility Phone: 239 789-2201
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIKTI A. GOSALIA
  • NPI Number: 1003406851
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2254502
LAB Type Physician Office
Facility Name VG PRIMARY CARE, PLLC
Street 5285 SUMMERLIN RD - STE E101
City FORT MYERS
State FL
ZIP 33919
Phone 239 789-2201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2024
Certificate Expiration Date 3/3/2026
Facility Type Physician Office
Lab Director VIKTI A. GOSALIA

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