10D0268245 CLIA NUMBER - JACK M MATHENY II MD

Laboratory Demographics

  • CLIA Code: 10D0268245
  • Facility Name: JACK M MATHENY II MD
  • Facility Address: 700 ZEAGLER DR STE 10
    PALATKA, FL
    ZIP 32177
  • Facility Phone: 386 328-6746
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACK M. MATHENY II
  • NPI Number: 1629040043
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D0268245
LAB Type Physician Office
Facility Name JACK M MATHENY II MD
Street 700 ZEAGLER DR STE 10
City PALATKA
State FL
ZIP 32177
Phone 386 328-6746
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Physician Office
Lab Director JACK M. MATHENY II

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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