10D0710260 CLIA NUMBER - PHYSICIANS GROUP SERVICES PA DBA FAMILY MEDICAL CENTERS

Laboratory Demographics

  • CLIA Code: 10D0710260
  • Facility Name: PHYSICIANS GROUP SERVICES PA DBA FAMILY MEDICAL CENTERS
  • Facility Address: 1906 SOUTHSIDE BLVD
    JACKSONVILLE, FL
    ZIP 32216
  • Facility Phone: 904 724-3083
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOUGLAS M. PENNINGTON
  • NPI Number: 1679737308
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0710260
LAB Type Physician Office
Facility Name PHYSICIANS GROUP SERVICES PA DBA FAMILY MEDICAL CENTERS
Street 1906 SOUTHSIDE BLVD
City JACKSONVILLE
State FL
ZIP 32216
Phone 904 724-3083
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Physician Office
Lab Director DOUGLAS M. PENNINGTON

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