10D1049723 CLIA NUMBER - TOMOKA SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 10D1049723
  • Facility Name: TOMOKA SURGERY CENTER
  • Facility Address: 345 CLYDE MORRIS BLVD STE 300
    ORMOND BEACH, FL
    ZIP 32174
  • Facility Phone: 386 672-7575
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARK E. KENNEDY MD
  • NPI Number: 1982637492
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1049723
LAB Type Ambulatory Surgery Center
Facility Name TOMOKA SURGERY CENTER
Street 345 CLYDE MORRIS BLVD STE 300
City ORMOND BEACH
State FL
ZIP 32174
Phone 386 672-7575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Ambulatory Surgery Center
Lab Director MARK E. KENNEDY MD

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