10D2005190 CLIA NUMBER - ELITE IMAGING LLC

Laboratory Demographics

  • CLIA Code: 10D2005190
  • Facility Name: ELITE IMAGING LLC
  • Facility Address: 2020 PROFESSIONAL CENTER DR
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 566-7768
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAURA M. KASSA
  • NPI Number: 1346516853
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2005190
LAB Type Physician Office
Facility Name ELITE IMAGING LLC
Street 2020 PROFESSIONAL CENTER DR
City ORANGE PARK
State FL
ZIP 32073
Phone 904 566-7768
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2025
Certificate Expiration Date 1/15/2027
Facility Type Physician Office
Lab Director LAURA M. KASSA

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