10D2110117 CLIA NUMBER - BLAINE PAYNE INC

Laboratory Demographics

  • CLIA Code: 10D2110117
  • Facility Name: BLAINE PAYNE INC
  • Facility Address: 180 NW HAYNES ST
    MADISON, FL
    ZIP 32340
  • Facility Phone: 954 882-8823
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THERESA BLAINE PAYNE
  • NPI Number: 1770943409
  • Taxonomy: 207QG0300X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2110117
LAB Type Physician Office
Facility Name BLAINE PAYNE INC
Street 180 NW HAYNES ST
City MADISON
State FL
ZIP 32340
Phone 954 882-8823
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2024
Certificate Expiration Date 3/8/2026
Facility Type Physician Office
Lab Director THERESA BLAINE PAYNE

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