10D2173238 CLIA NUMBER - AVECINA MEDICAL

Laboratory Demographics

CLIA Number: 10D2173238

Facility Name: AVECINA MEDICAL

Facility Address:
4160 SOUTHSIDE BLVD #10
JACKSONVILLE, FL
ZIP 32216
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Facility Phone Number: 904 900-1717

Facility Type: Other - URGENT CARE FACILITY

Certificate Type: Waiver

NPI Number: 1053981142

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2173238
LAB Type	Other - URGENT CARE FACILITY
Facility Name	AVECINA MEDICAL
Street	4160 SOUTHSIDE BLVD #10
City	JACKSONVILLE
State	FL
ZIP	32216
Phone	904 900-1717
CertificateType	4
CertificateEffectiveDate	10/8/2023
CertificateExpirationDate	10/7/2025
FacilityType	Waiver

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