10D2201091 CLIA NUMBER - WATSON HEALTHCARE

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Laboratory Demographics

CLIA Number: 10D2201091

Facility Name: WATSON HEALTHCARE

Facility Address:
413 5TH AVE NW SUITE A
JASPER, FL
ZIP 32052
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Facility Phone Number: 386 792-0700

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548872609

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2201091
LAB Type	Physician Office
Facility Name	WATSON HEALTHCARE
Street	413 5TH AVE NW SUITE A
City	JASPER
State	FL
ZIP	32052
Phone	386 792-0700
CertificateType	4
CertificateEffectiveDate	11/18/2022
CertificateExpirationDate	11/17/2024
FacilityType	Waiver

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