Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
10D2307919
|
|
Clinical laboratory number
|
|
Lab Name
|
IMPACT PRACTITIONER SERVICES LLC
|
|
Laboratory Name
|
|
Lab Type
|
Mobile Laboratory
|
|
Laboratory Type
|
|
Certificate Type
|
Waiver
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
772-295-7455
|
|
Laboratory telephone number
|
|
Fax
|
772-801-5459
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
3307 N INDIAN RIVER DRIVE
|
|
Primary location adress line
|
|
City
|
FORT PIERCE
|
|
Primary location city name
|
|
State
|
FL
|
|
Primary location state name
|
|
Zip
|
34946
|
|
Primary location postal code
|