10D2099235 CLIA NUMBER - PERRY VA CBOC

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Laboratory Demographics

CLIA Number: 10D2099235

Facility Name: PERRY VA CBOC

Facility Address:
1224 NORTH PEACOCK AVENUE
PERRY, FL
ZIP 32347
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Facility Phone Number: 857 203-5113

Facility Type: Community Clinic

Certificate Type: Accreditation

NPI Number: 1376910968

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2099235
LAB Type	Community Clinic
Facility Name	PERRY VA CBOC
Street	1224 NORTH PEACOCK AVENUE
City	PERRY
State	FL
ZIP	32347
Phone	857 203-5113
CertificateType	1
CertificateEffectiveDate	7/22/2015
CertificateExpirationDate	5/22/2026
FacilityType	Accreditation

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