10D0674990 CLIA NUMBER - FLORIDA DEPARTMENT OF HEALTH IN LAFAYETTE COUNTY

Laboratory Demographics

CLIA Number: 10D0674990

Facility Name: FLORIDA DEPARTMENT OF HEALTH IN LAFAYETTE COUNTY

Facility Address:
140 SW VIRGINIA CIRCLE
MAYO, FL
ZIP 32066
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Facility Phone Number: 386 294-1321

Facility Type: Public Health Laboratories

Certificate Type: Microscopy

NPI Number: 1386611085

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	10D0674990
LAB Type	Public Health Laboratories
Facility Name	FLORIDA DEPARTMENT OF HEALTH IN LAFAYETTE COUNTY
Street	140 SW VIRGINIA CIRCLE
City	MAYO
State	FL
ZIP	32066
Phone	386 294-1321
CertificateType	3
CertificateEffectiveDate	9/2/2022
CertificateExpirationDate	9/1/2024
FacilityType	PPMP

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