10D2142476 CLIA NUMBER - NORTH FL SURGEONS RIVER CITY ENT LLC

Laboratory Demographics

  • CLIA Code: 10D2142476
  • Facility Name: NORTH FL SURGEONS RIVER CITY ENT LLC
  • Facility Address: 14546 OLD ST AUGUSTINE RD STE 301
    JACKSONVILLE, FL
    ZIP 32258
  • Facility Phone: 904 202-6410
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUSTIN R. MOY
  • NPI Number: 1508163262
  • Taxonomy: 207RP1001X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2142476
LAB Type Physician Office
Facility Name NORTH FL SURGEONS RIVER CITY ENT LLC
Street 14546 OLD ST AUGUSTINE RD STE 301
City JACKSONVILLE
State FL
ZIP 32258
Phone 904 202-6410
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Physician Office
Lab Director JUSTIN R. MOY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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