10D2132139 CLIA NUMBER - HOLLY HILL HOME INFUSION SERVICE

Laboratory Demographics

  • CLIA Code: 10D2132139
  • Facility Name: HOLLY HILL HOME INFUSION SERVICE
  • Facility Address: 1702 RIDGEWOOD AVE
    HOLLY HILL, FL
    ZIP 32117
  • Facility Phone: 386 677-7377
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ERIC P. GICK
  • NPI Number: 1932109667
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2132139
LAB Type Home Health Agency
Facility Name HOLLY HILL HOME INFUSION SERVICE
Street 1702 RIDGEWOOD AVE
City HOLLY HILL
State FL
ZIP 32117
Phone 386 677-7377
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2025
Certificate Expiration Date 6/12/2027
Facility Type Home Health Agency
Lab Director ERIC P. GICK

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