10D0950915 CLIA NUMBER - ACQUAVIVAS PHARMACY

Laboratory Demographics

  • CLIA Code: 10D0950915
  • Facility Name: ACQUAVIVAS PHARMACY
  • Facility Address: 1555 PORT MALABAR BLVD NE STE 101
    PALM BAY, FL
    ZIP 32905
  • Facility Phone: 321 725-7188
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CARL D. ACQUAVIVA
  • NPI Number: 1780970673
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D0950915
LAB Type Pharmacy
Facility Name ACQUAVIVAS PHARMACY
Street 1555 PORT MALABAR BLVD NE STE 101
City PALM BAY
State FL
ZIP 32905
Phone 321 725-7188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Pharmacy
Lab Director CARL D. ACQUAVIVA

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