10D2288104 CLIA NUMBER - HEALING ADVANCED SOLUTIONS INC

Laboratory Demographics

CLIA Number: 10D2288104

Facility Name: HEALING ADVANCED SOLUTIONS INC

Facility Address:
11643 BEACH BOULEVARD
JACKSONVILLE, FL
ZIP 32246
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Facility Phone Number: 904 373-1661

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275269573

Taxonomy: 363LA2200X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2288104
LAB Type	Physician Office
Facility Name	HEALING ADVANCED SOLUTIONS INC
Street	11643 BEACH BOULEVARD
City	JACKSONVILLE
State	FL
ZIP	32246
Phone	904 373-1661
CertificateType	4
CertificateEffectiveDate	8/22/2023
CertificateExpirationDate	8/21/2025
FacilityType	Waiver

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