10D2125374 CLIA NUMBER - HEALTH PRO MEDICAL

Laboratory Demographics

CLIA Number: 10D2125374

Facility Name: HEALTH PRO MEDICAL

Facility Address:
8016 ATLANTIC BLVD
JACKSONVILLE, FL
ZIP 32211
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Facility Phone Number: 904 619-8687

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1376053124

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2125374
LAB Type	Physician Office
Facility Name	HEALTH PRO MEDICAL
Street	8016 ATLANTIC BLVD
City	JACKSONVILLE
State	FL
ZIP	32211
Phone	904 619-8687
CertificateType	4
CertificateEffectiveDate	2/7/2023
CertificateExpirationDate	2/6/2025
FacilityType	Waiver

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