10D2131342 CLIA NUMBER - FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC

Laboratory Demographics

CLIA Number: 10D2131342

Facility Name: FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC

Facility Address:
4689 US HWY 17 STE 2
FLEMING ISLAND, FL
ZIP 32003
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Facility Phone Number: 904 269-6526

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1376078634

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	10D2131342
LAB Type	Physician Office
Facility Name	FLORIDA CANCER SPECIALISTS & RESEARCH INSTITUTE, LLC
Street	4689 US HWY 17 STE 2
City	FLEMING ISLAND
State	FL
ZIP	32003
Phone	904 269-6526
CertificateType	1
CertificateEffectiveDate	7/12/2023
CertificateExpirationDate	7/11/2025
FacilityType	Accreditation

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