10D2090144 CLIA NUMBER - AMELIA EXPRESS CARE LLC

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Laboratory Demographics

CLIA Number: 10D2090144

Facility Name: AMELIA EXPRESS CARE LLC

Facility Address:
1987 SOUTH 8TH ST
FERNANDINA BEACH, FL
ZIP 32034
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Facility Phone Number: 904 624-7003

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1952701435

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2090144
LAB Type	Community Clinic
Facility Name	AMELIA EXPRESS CARE LLC
Street	1987 SOUTH 8TH ST
City	FERNANDINA BEACH
State	FL
ZIP	32034
Phone	904 624-7003
CertificateType	4
CertificateEffectiveDate	1/15/2023
CertificateExpirationDate	1/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024