10D2005902 CLIA NUMBER - PRC ASSOCIATES LLC

Laboratory Demographics

  • CLIA Code: 10D2005902
  • Facility Name: PRC ASSOCIATES LLC
  • Facility Address: 1165 DUNLAWTON AVE STE 101
    PORT ORANGE, FL
    ZIP 32127
  • Facility Phone: 386 760-0815
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINOD MALIK
  • NPI Number: 1902118201
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2005902
LAB Type Physician Office
Facility Name PRC ASSOCIATES LLC
Street 1165 DUNLAWTON AVE STE 101
City PORT ORANGE
State FL
ZIP 32127
Phone 386 760-0815
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2025
Certificate Expiration Date 2/17/2027
Facility Type Physician Office
Lab Director VINOD MALIK

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