10D2322151 CLIA NUMBER - LUNG MD DBA IDEAL PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D2322151
  • Facility Name: LUNG MD DBA IDEAL PRIMARY CARE
  • Facility Address: 4469 S CONGRESS AVE SUITE 106
    PALM SPRINGS, FL
    ZIP 33461
  • Facility Phone: 561 954-2731
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REBECCA A. CONNOLLY
  • NPI Number: 1891597050
  • Taxonomy: 207RP1001X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2322151
LAB Type Physician Office
Facility Name LUNG MD DBA IDEAL PRIMARY CARE
Street 4469 S CONGRESS AVE SUITE 106
City PALM SPRINGS
State FL
ZIP 33461
Phone 561 954-2731
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Physician Office
Lab Director REBECCA A. CONNOLLY

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