10D2329469 CLIA NUMBER - DE2 LLC DBA PANAMA PHARMACY 2

Laboratory Demographics

  • CLIA Code: 10D2329469
  • Facility Name: DE2 LLC DBA PANAMA PHARMACY 2
  • Facility Address: 6022 ATLANTIC BLVD
    JACKSONVILLE, FL
    ZIP 32211
  • Facility Phone: 904 990-1054
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL T. LEONARD
  • NPI Number: 1467954438
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2329469
LAB Type Pharmacy
Facility Name DE2 LLC DBA PANAMA PHARMACY 2
Street 6022 ATLANTIC BLVD
City JACKSONVILLE
State FL
ZIP 32211
Phone 904 990-1054
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2025
Certificate Expiration Date 8/27/2027
Facility Type Pharmacy
Lab Director PAUL T. LEONARD

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