10D2005609 CLIA NUMBER - ST LUCIE MEDICAL CENTER WOUND CARE CENTER

Laboratory Demographics

  • CLIA Code: 10D2005609
  • Facility Name: ST LUCIE MEDICAL CENTER WOUND CARE CENTER
  • Facility Address: 1871 SW TIFFANY AVE STE 210
    PORT SAINT LUCIE, FL
    ZIP 34952
  • Facility Phone: 772 398-3609
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: BERJAN COLLIN
  • NPI Number: 1922180249
  • Taxonomy: 208600000X - Surgery

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2005609
LAB Type Practitioner Other
Facility Name ST LUCIE MEDICAL CENTER WOUND CARE CENTER
Street 1871 SW TIFFANY AVE STE 210
City PORT SAINT LUCIE
State FL
ZIP 34952
Phone 772 398-3609
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2024
Certificate Expiration Date 3/30/2026
Facility Type Practitioner Other
Lab Director BERJAN COLLIN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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