10D2008172 CLIA NUMBER - JACKSONVILLE SPINE CENTER

Laboratory Demographics

  • CLIA Code: 10D2008172
  • Facility Name: JACKSONVILLE SPINE CENTER
  • Facility Address: 5191 FIRST COAST TECH PKWY FLOOR 3
    JACKSONVILLE, FL
    ZIP 32224
  • Facility Phone: 904 223-3321
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. AHMED IBRAHIM
  • NPI Number: 1891309340
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2008172
LAB Type Physician Office
Facility Name JACKSONVILLE SPINE CENTER
Street 5191 FIRST COAST TECH PKWY FLOOR 3
City JACKSONVILLE
State FL
ZIP 32224
Phone 904 223-3321
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 7/31/2025
Certificate Expiration Date 7/30/2027
Facility Type Physician Office
Lab Director DR. AHMED IBRAHIM

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