10D2010442 CLIA NUMBER - HALIFAX HEALTH CHILDRENS MEDICAL CENTER OF PORT ORANGE

Laboratory Demographics

  • CLIA Code: 10D2010442
  • Facility Name: HALIFAX HEALTH CHILDRENS MEDICAL CENTER OF PORT ORANGE
  • Facility Address: 5540 SOUTH WILLIAMSON BLVD, SUITE 104
    PORT ORANGE, FL
    ZIP 32128
  • Facility Phone: 386 523-1313
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SALMAN AHMED
  • NPI Number: 1093308504
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2010442
LAB Type Physician Office
Facility Name HALIFAX HEALTH CHILDRENS MEDICAL CENTER OF PORT ORANGE
Street 5540 SOUTH WILLIAMSON BLVD, SUITE 104
City PORT ORANGE
State FL
ZIP 32128
Phone 386 523-1313
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Physician Office
Lab Director SALMAN AHMED

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