10D2035315 CLIA NUMBER - FORT PIERCE FAMILY CARE INC

Laboratory Demographics

  • CLIA Code: 10D2035315
  • Facility Name: FORT PIERCE FAMILY CARE INC
  • Facility Address: 3851 VIRGINIA AVE
    FORT PIERCE, FL
    ZIP 34981
  • Facility Phone: 772 882-4919
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEROME JACOBSON
  • NPI Number: 1710271333
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2035315
LAB Type Physician Office
Facility Name FORT PIERCE FAMILY CARE INC
Street 3851 VIRGINIA AVE
City FORT PIERCE
State FL
ZIP 34981
Phone 772 882-4919
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Physician Office
Lab Director JEROME JACOBSON

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This page was last updated on: 3/20/2025