10D1041376 CLIA NUMBER - BREVARD SKIN AND CANCER CENTER

Laboratory Demographics

  • CLIA Code: 10D1041376
  • Facility Name: BREVARD SKIN AND CANCER CENTER
  • Facility Address: 8059 SPYGLASS HILL RD STE 103
    VIERA, FL
    ZIP 32940
  • Facility Phone: 321 636-7780
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MARIO J. SEQUEIRA
  • NPI Number: 1346226404
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D1041376
LAB Type Physician Office
Facility Name BREVARD SKIN AND CANCER CENTER
Street 8059 SPYGLASS HILL RD STE 103
City VIERA
State FL
ZIP 32940
Phone 321 636-7780
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Physician Office
Lab Director MARIO J. SEQUEIRA

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