10D2295633 CLIA NUMBER - CORNERSTONE CARE CLINIC LLC

Laboratory Demographics

  • CLIA Code: 10D2295633
  • Facility Name: CORNERSTONE CARE CLINIC LLC
  • Facility Address: 1520 OHIO AVE SOUTH
    LIVE OAK, FL
    ZIP 32064
  • Facility Phone: 386 219-4060
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHELLE D. MORRIS
  • NPI Number: 1669253639
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2295633
LAB Type Physician Office
Facility Name CORNERSTONE CARE CLINIC LLC
Street 1520 OHIO AVE SOUTH
City LIVE OAK
State FL
ZIP 32064
Phone 386 219-4060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Physician Office
Lab Director MICHELLE D. MORRIS

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