10D2121260 CLIA NUMBER - RADIOLOGY ASSOCIATES ORANGE PARK

Laboratory Demographics

  • CLIA Code: 10D2121260
  • Facility Name: RADIOLOGY ASSOCIATES ORANGE PARK
  • Facility Address: 2128 PARK AVE
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 386 274-7118
  • Facility Type: Other - OUTPATIENT IMAGING
  • Facility Type: Waiver
  • Lab Director: MARCIA L. WILSON
  • NPI Number: 1720536154
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2121260
LAB Type Other - OUTPATIENT IMAGING
Facility Name RADIOLOGY ASSOCIATES ORANGE PARK
Street 2128 PARK AVE
City ORANGE PARK
State FL
ZIP 32073
Phone 386 274-7118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2024
Certificate Expiration Date 11/1/2026
Facility Type Other - OUTPATIENT IMAGING
Lab Director MARCIA L. WILSON

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This page was last updated on: 3/20/2025