10D1056414 CLIA NUMBER - FRESENIUS MEDICAL CARE JAX BEACH DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 10D1056414
  • Facility Name: FRESENIUS MEDICAL CARE JAX BEACH DIALYSIS CENTER
  • Facility Address: 1711 S 5TH ST
    JACKSONVILLE BEACH, FL
    ZIP 32250
  • Facility Phone: 904 354-3333
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DINESH JAYADAVAPPA
  • NPI Number: 1447298419
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1056414
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FRESENIUS MEDICAL CARE JAX BEACH DIALYSIS CENTER
Street 1711 S 5TH ST
City JACKSONVILLE BEACH
State FL
ZIP 32250
Phone 904 354-3333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DINESH JAYADAVAPPA

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