10D2059250 CLIA NUMBER - RIVERSIDE SPINE AND PAIN CENTER

Laboratory Demographics

  • CLIA Code: 10D2059250
  • Facility Name: RIVERSIDE SPINE AND PAIN CENTER
  • Facility Address: 7740 POINT MEADOWS DR STE 6
    JACKSONVILLE, FL
    ZIP 32256
  • Facility Phone: 904 389-1010
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KISHA THOMAS
  • NPI Number: 1548594880
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2059250
LAB Type Physician Office
Facility Name RIVERSIDE SPINE AND PAIN CENTER
Street 7740 POINT MEADOWS DR STE 6
City JACKSONVILLE
State FL
ZIP 32256
Phone 904 389-1010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Physician Office
Lab Director KISHA THOMAS

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