10D2016818 CLIA NUMBER - PARTHENON MEDICAL CENTER LLC

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Laboratory Demographics

CLIA Number: 10D2016818

Facility Name: PARTHENON MEDICAL CENTER LLC

Facility Address:
5105 BOWDEN RD
JACKSONVILLE, FL
ZIP 32216
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Facility Phone Number: 813 362-1171

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1285117549

Taxonomy: 363LP2300X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2016818
LAB Type	Physician Office
Facility Name	PARTHENON MEDICAL CENTER LLC
Street	5105 BOWDEN RD
City	JACKSONVILLE
State	FL
ZIP	32216
Phone	813 362-1171
CertificateType	4
CertificateEffectiveDate	11/29/2022
CertificateExpirationDate	11/28/2024
FacilityType	Waiver

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