10D2264565 CLIA NUMBER - DR K PRIMARY CARE

Laboratory Demographics

CLIA Number: 10D2264565

Facility Name: DR K PRIMARY CARE

Facility Address:
3801 WOODBRIAR TRAIL
PORT ORANGE, FL
ZIP 32129
Get Directions

Facility Phone Number: 386 382-7177

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1215689757

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2264565
LAB Type	Physician Office
Facility Name	DR K PRIMARY CARE
Street	3801 WOODBRIAR TRAIL
City	PORT ORANGE
State	FL
ZIP	32129
Phone	386 382-7177
CertificateType	4
CertificateEffectiveDate	7/15/2022
CertificateExpirationDate	7/14/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024