10D0998572 CLIA NUMBER - WESTSIDE CENTER FOR CLINICAL RESEARCH

Laboratory Demographics

  • CLIA Code: 10D0998572
  • Facility Name: WESTSIDE CENTER FOR CLINICAL RESEARCH
  • Facility Address: 810 LANE AVE S
    JACKSONVILLE, FL
    ZIP 32205
  • Facility Phone: 904 693-1490
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: JACKSON DOWNEY HERMAN
  • NPI Number: 1215990627
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0998572
LAB Type Other
Facility Name WESTSIDE CENTER FOR CLINICAL RESEARCH
Street 810 LANE AVE S
City JACKSONVILLE
State FL
ZIP 32205
Phone 904 693-1490
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Other
Lab Director JACKSON DOWNEY HERMAN

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