10D2107861 CLIA NUMBER - SHANDS JACKSONVILLE MEDICAL CENTER INC DBA UF HEALTH ONCOLOGY FERNANDINA BEACH

Laboratory Demographics

CLIA Number: 10D2107861

Facility Name: SHANDS JACKSONVILLE MEDICAL CENTER INC DBA UF HEALTH ONCOLOGY FERNANDINA BEACH

Facility Address:
1699 S 14TH ST STE 2
FERNANDINA BEACH, FL
ZIP 32034
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Facility Phone Number: 904 427-1370

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1851892467

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	10D2107861
LAB Type	Physician Office
Facility Name	SHANDS JACKSONVILLE MEDICAL CENTER INC DBA UF HEALTH ONCOLOGY FERNANDINA BEACH
Street	1699 S 14TH ST STE 2
City	FERNANDINA BEACH
State	FL
ZIP	32034
Phone	904 427-1370
CertificateType	2
CertificateEffectiveDate	4/8/2024
CertificateExpirationDate	4/7/2026
FacilityType	Compliance

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