10D1072915 CLIA NUMBER - SUSAN C FAIR DO PA

Laboratory Demographics

  • CLIA Code: 10D1072915
  • Facility Name: SUSAN C FAIR DO PA
  • Facility Address: 595 N COURTENAY PKWY STE 102
    MERRITT ISLAND, FL
    ZIP 32953
  • Facility Phone: 321 455-1226
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUSAN C. FAIR
  • NPI Number: 1457351223
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D1072915
LAB Type Physician Office
Facility Name SUSAN C FAIR DO PA
Street 595 N COURTENAY PKWY STE 102
City MERRITT ISLAND
State FL
ZIP 32953
Phone 321 455-1226
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2025
Certificate Expiration Date 8/27/2027
Facility Type Physician Office
Lab Director SUSAN C. FAIR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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