10D1009122 CLIA NUMBER - IRMC PHYSICIAN NETWORK UROLOGY

Laboratory Demographics

  • CLIA Code: 10D1009122
  • Facility Name: IRMC PHYSICIAN NETWORK UROLOGY
  • Facility Address: 3450 11TH COURT SUITE 303
    VERO BEACH, FL
    ZIP 32960
  • Facility Phone: 772 567-4311
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHRISTOPHER P. TARDIF
  • NPI Number: 1376850560
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1009122
LAB Type Physician Office
Facility Name IRMC PHYSICIAN NETWORK UROLOGY
Street 3450 11TH COURT SUITE 303
City VERO BEACH
State FL
ZIP 32960
Phone 772 567-4311
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Physician Office
Lab Director CHRISTOPHER P. TARDIF

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This page was last updated on: 3/20/2025