10D1042392 CLIA NUMBER - RIVER REGION HUMAN SERVICES INC

Laboratory Demographics

CLIA Number: 10D1042392

Facility Name: RIVER REGION HUMAN SERVICES INC

Facility Address:
3901 CARMICHAEL AVENUE
JACKSONVILLE, FL
ZIP 32207
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Facility Phone Number: 904 899-6300

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1225623184

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1042392
LAB Type	Mobile Laboratory
Facility Name	RIVER REGION HUMAN SERVICES INC
Street	3901 CARMICHAEL AVENUE
City	JACKSONVILLE
State	FL
ZIP	32207
Phone	904 899-6300
CertificateType	4
CertificateEffectiveDate	6/30/2023
CertificateExpirationDate	6/29/2025
FacilityType	Waiver

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