10D2275562 CLIA NUMBER - FREEPORT PRIMARY AND IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 10D2275562
  • Facility Name: FREEPORT PRIMARY AND IMMEDIATE CARE
  • Facility Address: 902 HIGHWAY 20 E, STE 108
    FREEPORT, FL
    ZIP 32439
  • Facility Phone: (850) 332-2589
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY R. RUSSELL
  • NPI Number: 1861118564
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2275562
LAB Type Physician Office
Facility Name FREEPORT PRIMARY AND IMMEDIATE CARE
Street 902 HIGHWAY 20 E, STE 108
City FREEPORT
State FL
ZIP 32439
Phone 8503322589
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Physician Office
Lab Director AMY R. RUSSELL

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This page was last updated on: 5/18/2026