10D1037509 CLIA NUMBER - FLORIDA INSTITUTE FOR REPRODUCTIVE MEDICINE

Laboratory Demographics

CLIA Number: 10D1037509

Facility Name: FLORIDA INSTITUTE FOR REPRODUCTIVE MEDICINE

Facility Address:
415 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL
ZIP 32114
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Facility Phone Number: 386 254-8211

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1053994418

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D1037509
LAB Type	Physician Office
Facility Name	FLORIDA INSTITUTE FOR REPRODUCTIVE MEDICINE
Street	415 N CLYDE MORRIS BLVD
City	DAYTONA BEACH
State	FL
ZIP	32114
Phone	386 254-8211
CertificateType	2
CertificateEffectiveDate	4/1/2023
CertificateExpirationDate	3/31/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024