10D2300796 CLIA NUMBER - JC WELLNESS & PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 10D2300796
  • Facility Name: JC WELLNESS & PRIMARY CARE, LLC
  • Facility Address: 616 E ALTAMONTE DR - STE 203
    ALTAMONTE SPRINGS, FL
    ZIP 32701
  • Facility Phone: 407 701-7356
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KENISHA WOOD
  • NPI Number: 1346937737
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2300796
LAB Type Practitioner Other
Facility Name JC WELLNESS & PRIMARY CARE, LLC
Street 616 E ALTAMONTE DR - STE 203
City ALTAMONTE SPRINGS
State FL
ZIP 32701
Phone 407 701-7356
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Practitioner Other
Lab Director KENISHA WOOD

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