10D2258771 CLIA NUMBER - CENTER FOR HEALTH & SPORTS MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 10D2258771
  • Facility Name: CENTER FOR HEALTH & SPORTS MEDICINE, LLC
  • Facility Address: 4255 US HIGHWAY 1 SOUTH, UNIT 10
    ST AUGUSTINE, FL
    ZIP 32086
  • Facility Phone: 904 240-0565
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROSS OSBORN
  • NPI Number: 1780864223
  • Taxonomy: 103TC0700X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 10D2258771
LAB Type Physician Office
Facility Name CENTER FOR HEALTH & SPORTS MEDICINE, LLC
Street 4255 US HIGHWAY 1 SOUTH, UNIT 10
City ST AUGUSTINE
State FL
ZIP 32086
Phone 904 240-0565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type Physician Office
Lab Director ROSS OSBORN

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