10D2070560 CLIA NUMBER - ST VINCENT'S AMBULATORY CARE, INC

Laboratory Demographics

  • CLIA Code: 10D2070560
  • Facility Name: ST VINCENT'S AMBULATORY CARE, INC
  • Facility Address: 1895 KINGSLEY AVE - STE 903
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 644-8353
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARY A. KENNESON
  • NPI Number: 1558464529
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 10D2070560
LAB Type Physician Office
Facility Name ST VINCENT'S AMBULATORY CARE, INC
Street 1895 KINGSLEY AVE - STE 903
City ORANGE PARK
State FL
ZIP 32073
Phone 904 644-8353
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Physician Office
Lab Director MARY A. KENNESON

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