10D0269291 CLIA NUMBER - JACKSONVILLE SURGERY CENTER, LTD

Laboratory Demographics

CLIA Number: 10D0269291

Facility Name: JACKSONVILLE SURGERY CENTER, LTD

Facility Address:
7021 AC SKINNER PKWY
JACKSONVILLE, FL
ZIP 32256
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Facility Phone Number: 904 607-3984

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1134182546

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0269291
LAB Type	Ambulatory Surgery Center
Facility Name	JACKSONVILLE SURGERY CENTER, LTD
Street	7021 AC SKINNER PKWY
City	JACKSONVILLE
State	FL
ZIP	32256
Phone	904 607-3984
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024