10D0995168 CLIA NUMBER - SHANE C HERNESMAN MD PA

Laboratory Demographics

  • CLIA Code: 10D0995168
  • Facility Name: SHANE C HERNESMAN MD PA
  • Facility Address: 1980 N ATLANTIC AVE #630
    COCOA BEACH, FL
    ZIP 32931
  • Facility Phone: 321 453-5888
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANE C. HERNESMAN
  • NPI Number: 1952412652
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D0995168
LAB Type Physician Office
Facility Name SHANE C HERNESMAN MD PA
Street 1980 N ATLANTIC AVE #630
City COCOA BEACH
State FL
ZIP 32931
Phone 321 453-5888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Physician Office
Lab Director SHANE C. HERNESMAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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