10D1043111 CLIA NUMBER - CONCENTRA - JACKSONVILLE SOUTHSIDE

Laboratory Demographics

  • CLIA Code: 10D1043111
  • Facility Name: CONCENTRA - JACKSONVILLE SOUTHSIDE
  • Facility Address: 5995-1 UNIVERSITY BLVD, W
    JACKSONVILLE, FL
    ZIP 32216
  • Facility Phone: 904 737-7173
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARNOLDO BICHARA J. TOBAR
  • NPI Number: 1225567910
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1043111
LAB Type Physician Office
Facility Name CONCENTRA - JACKSONVILLE SOUTHSIDE
Street 5995-1 UNIVERSITY BLVD, W
City JACKSONVILLE
State FL
ZIP 32216
Phone 904 737-7173
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2025
Certificate Expiration Date 7/17/2027
Facility Type Physician Office
Lab Director ARNOLDO BICHARA J. TOBAR

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