10D2308890 CLIA NUMBER - VEEDHATA OM LLC DBA PRIME DIAGNOSTICS

Laboratory Demographics

  • CLIA Code: 10D2308890
  • Facility Name: VEEDHATA OM LLC DBA PRIME DIAGNOSTICS
  • Facility Address: 404 NW HALL OF FAME DR SUITE D
    LAKE CITY, FL
    ZIP 32055
  • Facility Phone: 917 272-3468
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. SAMIR GUNJAN
  • NPI Number: 1720810328
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 10D2308890
LAB Type Independent
Facility Name VEEDHATA OM LLC DBA PRIME DIAGNOSTICS
Street 404 NW HALL OF FAME DR SUITE D
City LAKE CITY
State FL
ZIP 32055
Phone 917 272-3468
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Independent
Lab Director DR. SAMIR GUNJAN

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