10D2270826 CLIA NUMBER - 904 HEALTH INC

Laboratory Demographics

  • CLIA Code: 10D2270826
  • Facility Name: 904 HEALTH INC
  • Facility Address: 96040 LOFTON SQUARE CT
    YULEE, FL
    ZIP 32097
  • Facility Phone: (904) 659-2475
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: PABLO PELLA
  • NPI Number: 1184305435
  • Taxonomy: 207RI0200X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2270826
LAB Type Community Clinic
Facility Name 904 HEALTH INC
Street 96040 LOFTON SQUARE CT
City YULEE
State FL
ZIP 32097
Phone 9046592475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2024
Certificate Expiration Date 10/20/2026
Facility Type Community Clinic
Lab Director PABLO PELLA

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This page was last updated on: 5/18/2026