10D2149164 CLIA NUMBER - MAYO CLINIC MANGURIAN LABORATORY

Laboratory Demographics

  • CLIA Code: 10D2149164
  • Facility Name: MAYO CLINIC MANGURIAN LABORATORY
  • Facility Address: 4500 SAN PABLO ROAD MANGURIAN BLDG
    JACKSONVILLE, FL
    ZIP 32224
  • Facility Phone: 904 953-2257
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER P. MARQUEZ
  • NPI Number: 1023405065
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2149164
LAB Type Ancillary Testing Site in Health Care Center
Facility Name MAYO CLINIC MANGURIAN LABORATORY
Street 4500 SAN PABLO ROAD MANGURIAN BLDG
City JACKSONVILLE
State FL
ZIP 32224
Phone 904 953-2257
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2024
Certificate Expiration Date 5/24/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director CHRISTOPHER P. MARQUEZ

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