10D2006233 CLIA NUMBER - OP MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 10D2006233
  • Facility Name: OP MEDICAL LLC
  • Facility Address: 1515 HERBERT ST STE 209
    PORT ORANGE, FL
    ZIP 32129
  • Facility Phone: 386 366-9119
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTHONY C. PICCHIELLO
  • NPI Number: 1144452582
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2006233
LAB Type Physician Office
Facility Name OP MEDICAL LLC
Street 1515 HERBERT ST STE 209
City PORT ORANGE
State FL
ZIP 32129
Phone 386 366-9119
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2024
Certificate Expiration Date 4/14/2026
Facility Type Physician Office
Lab Director ANTHONY C. PICCHIELLO

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