10D2312189 CLIA NUMBER - AVECINA MEDICAL PA

Laboratory Demographics

  • CLIA Code: 10D2312189
  • Facility Name: AVECINA MEDICAL PA
  • Facility Address: 9925 SAN JOSE BLVD UNIT 1
    JACKSONVILLE, FL
    ZIP 32257
  • Facility Phone: 904 230-6988
  • Facility Type: Other - URGENT CARE FACILITY
  • Facility Type: Waiver
  • Lab Director: DMITRIY MODEL
  • NPI Number: 1215082003
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2312189
LAB Type Other - URGENT CARE FACILITY
Facility Name AVECINA MEDICAL PA
Street 9925 SAN JOSE BLVD UNIT 1
City JACKSONVILLE
State FL
ZIP 32257
Phone 904 230-6988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Other - URGENT CARE FACILITY
Lab Director DMITRIY MODEL

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