10D0274460 CLIA NUMBER - NORTH BREVARD MEDICAL SUPPORT INC DBA PARRISH MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 10D0274460
  • Facility Name: NORTH BREVARD MEDICAL SUPPORT INC DBA PARRISH MEDICAL GROUP
  • Facility Address: 250 HARRISON STREET
    TITUSVILLE, FL
    ZIP 32780
  • Facility Phone: 321 267-1426
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VICTOR R. BOODHOO
  • NPI Number: 1689060873
  • Taxonomy: 251V00000X - Voluntary or Charitable

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CLIA Record

Field Name Field Value
CLIA Number 10D0274460
LAB Type Physician Office
Facility Name NORTH BREVARD MEDICAL SUPPORT INC DBA PARRISH MEDICAL GROUP
Street 250 HARRISON STREET
City TITUSVILLE
State FL
ZIP 32780
Phone 321 267-1426
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Physician Office
Lab Director VICTOR R. BOODHOO

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