10D2328223 CLIA NUMBER - JACKSONVILLE CONCIERGE MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 10D2328223
  • Facility Name: JACKSONVILLE CONCIERGE MEDICINE LLC
  • Facility Address: 5011 GATE PARKWAY BLDG 100, SUITE 100 PMB 1064
    JACKSONVILLE, FL
    ZIP 32256
  • Facility Phone: 904 925-1951
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KYLE A. MIKALS
  • NPI Number: 1891681037
  • Taxonomy: 261QM1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2328223
LAB Type Practitioner Other
Facility Name JACKSONVILLE CONCIERGE MEDICINE LLC
Street 5011 GATE PARKWAY BLDG 100, SUITE 100 PMB 1064
City JACKSONVILLE
State FL
ZIP 32256
Phone 904 925-1951
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Practitioner Other
Lab Director KYLE A. MIKALS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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