10D2277405 CLIA NUMBER - REJUVENE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 10D2277405
  • Facility Name: REJUVENE FAMILY MEDICINE
  • Facility Address: 531 S 6TH ST - STE C
    MACCLENNY, FL
    ZIP 32063
  • Facility Phone: 904 687-3021
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: RACHEL A. SIROIS
  • NPI Number: 1073219523
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2277405
LAB Type Practitioner Other
Facility Name REJUVENE FAMILY MEDICINE
Street 531 S 6TH ST - STE C
City MACCLENNY
State FL
ZIP 32063
Phone 904 687-3021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Practitioner Other
Lab Director RACHEL A. SIROIS

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