10D2017795 CLIA NUMBER - PACIFICA CARE PLLC

Home > CLIA Lookup > 10D2017795

Laboratory Demographics

CLIA Number: 10D2017795

Facility Name: PACIFICA CARE PLLC

Facility Address:
13121 ATLANTIC BLVD STE 100
JACKSONVILLE, FL
ZIP 32225
Get Directions

Facility Phone Number: 904 221-2232

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1669775037

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	10D2017795
LAB Type	Physician Office
Facility Name	PACIFICA CARE PLLC
Street	13121 ATLANTIC BLVD STE 100
City	JACKSONVILLE
State	FL
ZIP	32225
Phone	904 221-2232
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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