10D2309118 CLIA NUMBER - PREMIER ASSISTED LIVING FACILITY, LLC

Laboratory Demographics

  • CLIA Code: 10D2309118
  • Facility Name: PREMIER ASSISTED LIVING FACILITY, LLC
  • Facility Address: 319 ELDRIDGE AVE
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 541-4605
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JESSICA M. VANCE
  • NPI Number: 1962140210
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2309118
LAB Type Assisted Living Facility
Facility Name PREMIER ASSISTED LIVING FACILITY, LLC
Street 319 ELDRIDGE AVE
City ORANGE PARK
State FL
ZIP 32073
Phone 904 541-4605
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Assisted Living Facility
Lab Director JESSICA M. VANCE

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