10D2066412 CLIA NUMBER - RIVERSIDE PAIN PHYSICIANS

Laboratory Demographics

  • CLIA Code: 10D2066412
  • Facility Name: RIVERSIDE PAIN PHYSICIANS
  • Facility Address: 4312 PABLO PROFESSIONAL CT
    JACKSONVILLE, FL
    ZIP 32240
  • Facility Phone: 904 270-2706
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: COLE LINVILLE
  • NPI Number: 1659747822
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D2066412
LAB Type Physician Office
Facility Name RIVERSIDE PAIN PHYSICIANS
Street 4312 PABLO PROFESSIONAL CT
City JACKSONVILLE
State FL
ZIP 32240
Phone 904 270-2706
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2025
Certificate Expiration Date 9/25/2027
Facility Type Physician Office
Lab Director COLE LINVILLE

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