10D2090068 CLIA NUMBER - CRAFT BEHAVIORAL HEALTH LLC

Laboratory Demographics

  • CLIA Code: 10D2090068
  • Facility Name: CRAFT BEHAVIORAL HEALTH LLC
  • Facility Address: 10175 FORTUNE PKWY STE 1106
    JACKSONVILLE, FL
    ZIP 32256
  • Facility Phone: 904 379-5928
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHAMMAD FOROOQUE
  • NPI Number: 1639491632
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 10D2090068
LAB Type Physician Office
Facility Name CRAFT BEHAVIORAL HEALTH LLC
Street 10175 FORTUNE PKWY STE 1106
City JACKSONVILLE
State FL
ZIP 32256
Phone 904 379-5928
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Physician Office
Lab Director MOHAMMAD FOROOQUE

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