10D1054592 CLIA NUMBER - FIRST COAST DERMATOLOGY, PA

Laboratory Demographics

  • CLIA Code: 10D1054592
  • Facility Name: FIRST COAST DERMATOLOGY, PA
  • Facility Address: 4487 BAYMEADOWS RD
    JACKSONVILLE, FL
    ZIP 32217
  • Facility Phone: 904 731-8300
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JUAN A. ROSARIO-COLLAZO
  • NPI Number: 1699968651
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D1054592
LAB Type Physician Office
Facility Name FIRST COAST DERMATOLOGY, PA
Street 4487 BAYMEADOWS RD
City JACKSONVILLE
State FL
ZIP 32217
Phone 904 731-8300
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Physician Office
Lab Director JUAN A. ROSARIO-COLLAZO

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