10D0911030 CLIA NUMBER - BREVARD SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 10D0911030
  • Facility Name: BREVARD SURGERY CENTER
  • Facility Address: 665 APOLLO BLVD
    MELBOURNE, FL
    ZIP 32901
  • Facility Phone: 321 984-0300
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RAFAEL TRESPALACIOS
  • NPI Number: 1770528838
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0911030
LAB Type Ambulatory Surgery Center
Facility Name BREVARD SURGERY CENTER
Street 665 APOLLO BLVD
City MELBOURNE
State FL
ZIP 32901
Phone 321 984-0300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Ambulatory Surgery Center
Lab Director RAFAEL TRESPALACIOS

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