10D1021162 CLIA NUMBER - VINCENT IVERS MD

Laboratory Demographics

  • CLIA Code: 10D1021162
  • Facility Name: VINCENT IVERS MD
  • Facility Address: 301 20TH ST
    PORT SAINT JOE, FL
    ZIP 32456
  • Facility Phone: 850 227-7070
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: VINCENT IVERS MD
  • NPI Number: 1851366702
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D1021162
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name VINCENT IVERS MD
Street 301 20TH ST
City PORT SAINT JOE
State FL
ZIP 32456
Phone 850 227-7070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director VINCENT IVERS MD

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