10D2300384 CLIA NUMBER - CELEBRATE PRIMARY CARE LLC

Laboratory Demographics

CLIA Number: 10D2300384

Facility Name: CELEBRATE PRIMARY CARE LLC

Facility Address:
919 NW 57TH ST SUITE #10
GAINESVILLE, FL
ZIP 32605
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Facility Phone Number: 352 474-8686

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1982143079

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2300384
LAB Type	Practitioner Other
Facility Name	CELEBRATE PRIMARY CARE LLC
Street	919 NW 57TH ST SUITE #10
City	GAINESVILLE
State	FL
ZIP	32605
Phone	352 474-8686
CertificateType	4
CertificateEffectiveDate	3/8/2024
CertificateExpirationDate	3/7/2026
FacilityType	Waiver

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