10D2311428 CLIA NUMBER - UPPERLINE HEALTHCARE PC

Laboratory Demographics

  • CLIA Code: 10D2311428
  • Facility Name: UPPERLINE HEALTHCARE PC
  • Facility Address: 1890 LPGA BLVD SUITE 250
    DAYTONA BEACH, FL
    ZIP 32117
  • Facility Phone: 386 339-4065
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES RUST
  • NPI Number: 1639904964
  • Taxonomy: 213ES0103X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 10D2311428
LAB Type Physician Office
Facility Name UPPERLINE HEALTHCARE PC
Street 1890 LPGA BLVD SUITE 250
City DAYTONA BEACH
State FL
ZIP 32117
Phone 386 339-4065
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Physician Office
Lab Director JAMES RUST

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