10D0693029 CLIA NUMBER - INTERNAL MEDICINE ASSOCIATES OF JACKSON HOSPITAL

Laboratory Demographics

  • CLIA Code: 10D0693029
  • Facility Name: INTERNAL MEDICINE ASSOCIATES OF JACKSON HOSPITAL
  • Facility Address: 4318 5TH AVE
    MARIANNA, FL
    ZIP 32446
  • Facility Phone: 850 526-5300
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: STEVEN W. SPENCE
  • NPI Number: 1205873841
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0693029
LAB Type Physician Office
Facility Name INTERNAL MEDICINE ASSOCIATES OF JACKSON HOSPITAL
Street 4318 5TH AVE
City MARIANNA
State FL
ZIP 32446
Phone 850 526-5300
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Physician Office
Lab Director STEVEN W. SPENCE

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