10D0884275 CLIA NUMBER - JAY MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 10D0884275

Facility Name: JAY MEDICAL CLINIC

Facility Address:
14088 ALABAMA STREET
JAY, FL
ZIP 32565
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Facility Phone Number: 850 675-4546

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1255398228

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0884275
LAB Type	Other
Facility Name	JAY MEDICAL CLINIC
Street	14088 ALABAMA STREET
City	JAY
State	FL
ZIP	32565
Phone	850 675-4546
CertificateType	4
CertificateEffectiveDate	7/30/2023
CertificateExpirationDate	7/29/2025
FacilityType	Waiver

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