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

Laboratory Demographics

CLIA Number: 10D2010442

Facility Name: HALIFAX HEALTH CHILDRENS MEDICAL CENTER OF PORT ORANGE

Facility Address:
5540 SOUTH WILLIAMSON BLVD, SUITE 104
PORT ORANGE, FL
ZIP 32128
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Facility Phone Number: 386 523-1313

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1215978010

Taxonomy: 207P00000X - Emergency Medicine
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

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
CertificateType 4
CertificateEffectiveDate 7/28/2022
CertificateExpirationDate 7/27/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024