10D2013182 CLIA NUMBER - PALATKA VA CBOC

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Laboratory Demographics

CLIA Number: 10D2013182

Facility Name: PALATKA VA CBOC

Facility Address:
400 NORTH STATE ROAD 19
PALATKA, FL
ZIP 32177
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Facility Phone Number: 010 101-1100

Facility Type: Community Clinic

Certificate Type: Accreditation

NPI Number: 1508172628

Taxonomy: 261QV0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2013182
LAB Type	Community Clinic
Facility Name	PALATKA VA CBOC
Street	400 NORTH STATE ROAD 19
City	PALATKA
State	FL
ZIP	32177
Phone	010 101-1100
CertificateType	1
CertificateEffectiveDate	9/15/2010
CertificateExpirationDate	5/22/2026
FacilityType	Accreditation

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This page was last updated on: 4/23/2024