10D0715637 CLIA NUMBER - ORMOND MEDICAL ARTS FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 10D0715637
  • Facility Name: ORMOND MEDICAL ARTS FAMILY PRACTICE LLC
  • Facility Address: 401 VENTURE DRIVE UNIT A
    SOUTH DAYTONA, FL
    ZIP 32119
  • Facility Phone: 904 761-8888
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT HARPOLD
  • NPI Number: 1346063161
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 10D0715637
LAB Type Physician Office
Facility Name ORMOND MEDICAL ARTS FAMILY PRACTICE LLC
Street 401 VENTURE DRIVE UNIT A
City SOUTH DAYTONA
State FL
ZIP 32119
Phone 904 761-8888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2025
Certificate Expiration Date 8/29/2027
Facility Type Physician Office
Lab Director ROBERT HARPOLD

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