22D2309297 CLIA NUMBER - DYNAMIC PRIMARY CARE PRACTICE, LLC

Laboratory Demographics

  • CLIA Code: 22D2309297
  • Facility Name: DYNAMIC PRIMARY CARE PRACTICE, LLC
  • Facility Address: 67 UNION STREET, UNIT 305
    NATICK, MA
    ZIP 01760
  • Facility Phone: 508 479-8038
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CHIKAEBERE TOURE
  • NPI Number: 1750151205
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 22D2309297
LAB Type Practitioner Other
Facility Name DYNAMIC PRIMARY CARE PRACTICE, LLC
Street 67 UNION STREET, UNIT 305
City NATICK
State MA
ZIP 01760
Phone 508 479-8038
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Practitioner Other
Lab Director CHIKAEBERE TOURE

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