10D1097649 CLIA NUMBER - SPACE COAST SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 10D1097649
  • Facility Name: SPACE COAST SURGERY CENTER
  • Facility Address: 595 N COURTENAY PKWY #103
    MERRITT ISLAND, FL
    ZIP 32953
  • Facility Phone: 321 890-1800
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ASHISH UDESHI
  • NPI Number: 1164662912
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1097649
LAB Type Ambulatory Surgery Center
Facility Name SPACE COAST SURGERY CENTER
Street 595 N COURTENAY PKWY #103
City MERRITT ISLAND
State FL
ZIP 32953
Phone 321 890-1800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Ambulatory Surgery Center
Lab Director ASHISH UDESHI

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