10D2129760 CLIA NUMBER - ID CONSULTS AND SERVICES, PA

Laboratory Demographics

  • CLIA Code: 10D2129760
  • Facility Name: ID CONSULTS AND SERVICES, PA
  • Facility Address: 3142 NORTHSIDE DR, STE 101
    KEY WEST, FL
    ZIP 33040
  • Facility Phone: 770 977-5056
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JERRY J. JACKSON
  • NPI Number: 1043551468
  • Taxonomy: 207RI0200X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2129760
LAB Type Physician Office
Facility Name ID CONSULTS AND SERVICES, PA
Street 3142 NORTHSIDE DR, STE 101
City KEY WEST
State FL
ZIP 33040
Phone 770 977-5056
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2025
Certificate Expiration Date 4/24/2027
Facility Type Physician Office
Lab Director JERRY J. JACKSON

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