10D0275976 CLIA NUMBER - REVERE MEDICAL

Laboratory Demographics

  • CLIA Code: 10D0275976
  • Facility Name: REVERE MEDICAL
  • Facility Address: 7227 US HWY 1 SUITE 220
    COCOA, FL
    ZIP 32927
  • Facility Phone: 321 636-2621
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PATRICIA ALEXANDER
  • NPI Number: 1104367630
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 10D0275976
LAB Type Physician Office
Facility Name REVERE MEDICAL
Street 7227 US HWY 1 SUITE 220
City COCOA
State FL
ZIP 32927
Phone 321 636-2621
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Physician Office
Lab Director DR. PATRICIA ALEXANDER

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