10D1099286 CLIA NUMBER - PHYSICIANS GROUP SERVICES PA DBA COASTAL FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 10D1099286
  • Facility Name: PHYSICIANS GROUP SERVICES PA DBA COASTAL FAMILY MEDICINE
  • Facility Address: 421 KINGSLEY AVE STE 300
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 282-6331
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL EDWARDS
  • NPI Number: 1003489865
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1099286
LAB Type Physician Office
Facility Name PHYSICIANS GROUP SERVICES PA DBA COASTAL FAMILY MEDICINE
Street 421 KINGSLEY AVE STE 300
City ORANGE PARK
State FL
ZIP 32073
Phone 904 282-6331
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Physician Office
Lab Director MICHAEL EDWARDS

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