10D1068972 CLIA NUMBER - LAKEVIEW HEALTH SYSTEMS LLC

Laboratory Demographics

CLIA Number: 10D1068972

Facility Name: LAKEVIEW HEALTH SYSTEMS LLC

Facility Address:
1900 CORPORATE SQUARE BLVD
JACKSONVILLE, FL
ZIP 32216
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Facility Phone Number: 904 227-6455

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1760548184

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	10D1068972
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	LAKEVIEW HEALTH SYSTEMS LLC
Street	1900 CORPORATE SQUARE BLVD
City	JACKSONVILLE
State	FL
ZIP	32216
Phone	904 227-6455
CertificateType	4
CertificateEffectiveDate	5/24/2023
CertificateExpirationDate	5/23/2025
FacilityType	Waiver

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