10D2127779 CLIA NUMBER - RIVIERA BEACH INTEGRATED CARE INC

Laboratory Demographics

  • CLIA Code: 10D2127779
  • Facility Name: RIVIERA BEACH INTEGRATED CARE INC
  • Facility Address: 31 W 20TH STREET
    RIVIERA BEACH, FL
    ZIP 33404
  • Facility Phone: 561 510-0471
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAILYA J. WOODEN
  • NPI Number: 1235578287
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2127779
LAB Type Physician Office
Facility Name RIVIERA BEACH INTEGRATED CARE INC
Street 31 W 20TH STREET
City RIVIERA BEACH
State FL
ZIP 33404
Phone 561 510-0471
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2025
Certificate Expiration Date 3/19/2027
Facility Type Physician Office
Lab Director JAILYA J. WOODEN

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This page was last updated on: 6/4/2025