10D2269927 CLIA NUMBER - FIRST COAST COMMUNITY WELLNESS SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 10D2269927
  • Facility Name: FIRST COAST COMMUNITY WELLNESS SERVICES, LLC
  • Facility Address: 3636 UNIVERSITY BLVD SOUTH SUITE A7,
    JACKSONVILLE, FL
    ZIP 32216
  • Facility Phone: 904 497-2192
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MONICA JOHNSON
  • NPI Number: 1336879097
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2269927
LAB Type Physician Office
Facility Name FIRST COAST COMMUNITY WELLNESS SERVICES, LLC
Street 3636 UNIVERSITY BLVD SOUTH SUITE A7,
City JACKSONVILLE
State FL
ZIP 32216
Phone 904 497-2192
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Physician Office
Lab Director MONICA JOHNSON

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