10D2242216 CLIA NUMBER - FIRST STOP HEALTHCARE, PLLC

Laboratory Demographics

CLIA Number: 10D2242216

Facility Name: FIRST STOP HEALTHCARE, PLLC

Facility Address:
1912 HAMILTON ST UNIT 205
JACKSONVILLE, FL
ZIP 32210
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Facility Phone Number: 904 544-3007

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1942806690

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2242216
LAB Type	Practitioner Other
Facility Name	FIRST STOP HEALTHCARE, PLLC
Street	1912 HAMILTON ST UNIT 205
City	JACKSONVILLE
State	FL
ZIP	32210
Phone	904 544-3007
CertificateType	4
CertificateEffectiveDate	11/5/2023
CertificateExpirationDate	11/4/2025
FacilityType	Waiver

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