10D2277198 CLIA NUMBER - SOUTHEAST ORTHOPEDIC SPECIALIST LLC

Laboratory Demographics

  • CLIA Code: 10D2277198
  • Facility Name: SOUTHEAST ORTHOPEDIC SPECIALIST LLC
  • Facility Address: 10475 CENTURION PKWY N ST 301
    JACKSONVILLE, FL
    ZIP 32256
  • Facility Phone: 904 634-0640
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FRANK COLLIER JR
  • NPI Number: 1396469797
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 10D2277198
LAB Type Physician Office
Facility Name SOUTHEAST ORTHOPEDIC SPECIALIST LLC
Street 10475 CENTURION PKWY N ST 301
City JACKSONVILLE
State FL
ZIP 32256
Phone 904 634-0640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Physician Office
Lab Director FRANK COLLIER JR

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