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Individual

MR. AKINKAWON TAHIR FRIERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LABORATORY DIRECTOR

Contact information

Practice address
2744 US 1 S, ST AUGUSTINE, FL 32086-6366
(888) 890-1054
(904) 600-4583
Mailing address
2744 US HIGHWAY 1 S, ST AUGUSTINE, FL 32086-6366
(904) 217-0479
(904) 600-4583

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
291U00000X
Clinical Medical Laboratory
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10D2240563
CLINICAL LABORATORY IMPROVEMENT AMENDMENTS CERTIFICATE OF WAIVER
FL
Enumeration date
12/18/2021
Last updated
10/24/2025
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