10D2272284 CLIA NUMBER - AFFIRM DIRECT PRIMARY CARE PA

Laboratory Demographics

  • CLIA Code: 10D2272284
  • Facility Name: AFFIRM DIRECT PRIMARY CARE PA
  • Facility Address: 6871 BELFORT OAK PLACE SUITE 300
    JACKSONVILLE, FL
    ZIP 32216
  • Facility Phone: (904) 839-1990
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHNIQUE C. BENNETT
  • NPI Number: 1629811930
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2272284
LAB Type Physician Office
Facility Name AFFIRM DIRECT PRIMARY CARE PA
Street 6871 BELFORT OAK PLACE SUITE 300
City JACKSONVILLE
State FL
ZIP 32216
Phone 9048391990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2024
Certificate Expiration Date 11/16/2026
Facility Type Physician Office
Lab Director JOHNIQUE C. BENNETT

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