10D2240008 CLIA NUMBER - JACKSON DRUGS LLC

Laboratory Demographics

CLIA Number: 10D2240008

Facility Name: JACKSON DRUGS LLC

Facility Address:
2301 OKEECHOBEE RD
FORT PIERCE, FL
ZIP 34950
Get Directions

Facility Phone Number: 347 239-2790

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1124161435

Taxonomy: 261QD1600X - Clinic/Center
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

CLIA Record

Field Name	Field Value
CLIA Number	10D2240008
LAB Type	Pharmacy
Facility Name	JACKSON DRUGS LLC
Street	2301 OKEECHOBEE RD
City	FORT PIERCE
State	FL
ZIP	34950
Phone	347 239-2790
CertificateType	4
CertificateEffectiveDate	10/15/2023
CertificateExpirationDate	10/14/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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