10D0994011 CLIA NUMBER - DONNA BACON MD

Laboratory Demographics

  • CLIA Code: 10D0994011
  • Facility Name: DONNA BACON MD
  • Facility Address: 1282 US 1 SUITE 1
    ROCKLEDGE, FL
    ZIP 32955
  • Facility Phone: 321 631-3693
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONNA L. BACON
  • NPI Number: 1215934476
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0994011
LAB Type Physician Office
Facility Name DONNA BACON MD
Street 1282 US 1 SUITE 1
City ROCKLEDGE
State FL
ZIP 32955
Phone 321 631-3693
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Physician Office
Lab Director DONNA L. BACON

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