10D0943201 CLIA NUMBER - COASTAL FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 10D0943201
  • Facility Name: COASTAL FAMILY PRACTICE
  • Facility Address: 1404 S RIDGEWOOD AVE
    EDGEWATER, FL
    ZIP 32132
  • Facility Phone: 386 426-8166
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARGARET M. CHANG
  • NPI Number: 1275552358
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0943201
LAB Type Physician Office
Facility Name COASTAL FAMILY PRACTICE
Street 1404 S RIDGEWOOD AVE
City EDGEWATER
State FL
ZIP 32132
Phone 386 426-8166
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director MARGARET M. CHANG

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