10D1040259 CLIA NUMBER - FIRST COAST DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 10D1040259

Facility Name: FIRST COAST DIALYSIS CENTER

Facility Address:
5730 BOWDEN RD STE 110
JACKSONVILLE, FL
ZIP 32216
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Facility Phone Number: 904 354-3333

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1740477843

Taxonomy: 207RI0200X - Internal Medicine
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

CLIA Record

Field Name	Field Value
CLIA Number	10D1040259
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FIRST COAST DIALYSIS CENTER
Street	5730 BOWDEN RD STE 110
City	JACKSONVILLE
State	FL
ZIP	32216
Phone	904 354-3333
CertificateType	4
CertificateEffectiveDate	5/4/2023
CertificateExpirationDate	5/3/2025
FacilityType	Waiver

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