10D0266875 CLIA NUMBER - BRUCE S WEST MD

Laboratory Demographics

  • CLIA Code: 10D0266875
  • Facility Name: BRUCE S WEST MD
  • Facility Address: 1340 S 18TH ST STE 203
    FERNANDINA BEACH, FL
    ZIP 32034
  • Facility Phone: 904 261-7707
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRUCE S. WEST
  • NPI Number: 1588632780
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0266875
LAB Type Physician Office
Facility Name BRUCE S WEST MD
Street 1340 S 18TH ST STE 203
City FERNANDINA BEACH
State FL
ZIP 32034
Phone 904 261-7707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Physician Office
Lab Director BRUCE S. WEST

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