10D1087594 CLIA NUMBER - R K VISHEN MD PA

Laboratory Demographics

  • CLIA Code: 10D1087594
  • Facility Name: R K VISHEN MD PA
  • Facility Address: 165 WELLS RD STE 404
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 264-3111
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: RAJ K. VISHEN
  • NPI Number: 1912011511
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1087594
LAB Type Practitioner Other
Facility Name R K VISHEN MD PA
Street 165 WELLS RD STE 404
City ORANGE PARK
State FL
ZIP 32073
Phone 904 264-3111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2024
Certificate Expiration Date 8/6/2026
Facility Type Practitioner Other
Lab Director RAJ K. VISHEN

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