10D2282150 CLIA NUMBER - TRENTON MEDICAL CENTER INC DBA PALMS MEDICAL GROUP

Laboratory Demographics

CLIA Number: 10D2282150

Facility Name: TRENTON MEDICAL CENTER INC DBA PALMS MEDICAL GROUP

Facility Address:
2349 VILLAGE SQUARE PKWY STE 110
FLEMING ISLAND, FL
ZIP 32003
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Facility Phone Number: 904 385-2023

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1275220238

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2282150
LAB Type	Federally Qualified Health Center
Facility Name	TRENTON MEDICAL CENTER INC DBA PALMS MEDICAL GROUP
Street	2349 VILLAGE SQUARE PKWY STE 110
City	FLEMING ISLAND
State	FL
ZIP	32003
Phone	904 385-2023
CertificateType	3
CertificateEffectiveDate	5/17/2023
CertificateExpirationDate	5/16/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024