10D1096478 CLIA NUMBER - PRISAT PA

Laboratory Demographics

  • CLIA Code: 10D1096478
  • Facility Name: PRISAT PA
  • Facility Address: 3685 CROWN POINT COURT
    JACKSONVILLE, FL
    ZIP 32257
  • Facility Phone: 904 880-8840
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRTIA S. MADKAIKER
  • NPI Number: 1275678799
  • Taxonomy: 163WP0808X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 10D1096478
LAB Type Physician Office
Facility Name PRISAT PA
Street 3685 CROWN POINT COURT
City JACKSONVILLE
State FL
ZIP 32257
Phone 904 880-8840
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Physician Office
Lab Director PRTIA S. MADKAIKER

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