10D1020618 CLIA NUMBER - NABIL S ITANI DO PA

Laboratory Demographics

  • CLIA Code: 10D1020618
  • Facility Name: NABIL S ITANI DO PA
  • Facility Address: 875 CENTURY MEDICAL DR
    TITUSVILLE, FL
    ZIP 32796
  • Facility Phone: 321 268-8787
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NABIL S. ITANI
  • NPI Number: 1912009168
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1020618
LAB Type Physician Office
Facility Name NABIL S ITANI DO PA
Street 875 CENTURY MEDICAL DR
City TITUSVILLE
State FL
ZIP 32796
Phone 321 268-8787
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/24/2023
Certificate Expiration Date 12/23/2025
Facility Type Physician Office
Lab Director NABIL S. ITANI

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