10D0022596 CLIA NUMBER - MOOSEHAVEN HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 10D0022596
  • Facility Name: MOOSEHAVEN HEALTH CENTER
  • Facility Address: 1701 PARK AVENUE
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 278-1200
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL A. STEPHENS MD
  • NPI Number: 1831311398
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0022596
LAB Type Ancillary Testing Site in Health Care Center
Facility Name MOOSEHAVEN HEALTH CENTER
Street 1701 PARK AVENUE
City ORANGE PARK
State FL
ZIP 32073
Phone 904 278-1200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director MICHAEL A. STEPHENS MD

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