10D2105214 CLIA NUMBER - FIRST COAST PSYCHIATRIC SERVICES

Laboratory Demographics

  • CLIA Code: 10D2105214
  • Facility Name: FIRST COAST PSYCHIATRIC SERVICES
  • Facility Address: 1543 KINGSLEY AVE STE 14
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 375-9679
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: UBAID A. KHOKHAR
  • NPI Number: 1699137182
  • Taxonomy: 2080P0208X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2105214
LAB Type Physician Office
Facility Name FIRST COAST PSYCHIATRIC SERVICES
Street 1543 KINGSLEY AVE STE 14
City ORANGE PARK
State FL
ZIP 32073
Phone 904 375-9679
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Physician Office
Lab Director UBAID A. KHOKHAR

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