10D0976317 CLIA NUMBER - FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC

Laboratory Demographics

CLIA Number: 10D0976317

Facility Name: FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC

Facility Address:
1215 DUNN AVE SUITE 3
JACKSONVILLE, FL
ZIP 32218
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Facility Phone Number: 904 757-1997

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1386147882

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0976317
LAB Type	Physician Office
Facility Name	FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC
Street	1215 DUNN AVE SUITE 3
City	JACKSONVILLE
State	FL
ZIP	32218
Phone	904 757-1997
CertificateType	4
CertificateEffectiveDate	3/13/2023
CertificateExpirationDate	3/12/2025
FacilityType	Waiver

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