10D1020840 CLIA NUMBER - MERCY MEDICAL URGENT CARE CENTER INC

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Laboratory Demographics

CLIA Number: 10D1020840

Facility Name: MERCY MEDICAL URGENT CARE CENTER INC

Facility Address:
2786 W US HWY 90, SUITE 105
LAKE CITY, FL
ZIP 32055
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Facility Phone Number: 386 758-2944

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1891113064

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1020840
LAB Type	Physician Office
Facility Name	MERCY MEDICAL URGENT CARE CENTER INC
Street	2786 W US HWY 90, SUITE 105
City	LAKE CITY
State	FL
ZIP	32055
Phone	386 758-2944
CertificateType	4
CertificateEffectiveDate	8/21/2023
CertificateExpirationDate	8/20/2025
FacilityType	Waiver

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